Flossing

At forty one years of age, I found myself in a dentist's office recently for a cleaning; for the first time in all those years, I was actually taught how to floss my teeth!

I have a very bad flossing history. About as often as I noticed that half of my ¹⁴⁵Sm was missing[1], the guilt would hit me and I would give it a try again. I'd contort my body this way and that for a few minutes, looking like a raccoon trying to get a bee out of its mouth, and give up after a few minutes, having gained a bit of a sore jaw while instilling not an iota of fear in the bacteria chortling behind my periodontal ramparts. Not only was it difficult to get the string positioned, but (as I found out last week) my teeth are packed together a bit tighter than normal.

But thanks to the tutelage of a very good dental technician, I am now a bona fide twice-a-day flosser.

So here's the drill:

1. Cut off a length of floss at least two feet (60 cm) long -- maybe three. Mistake number one that I'd always made was to use just two inches or so.
2. Wind one end around the middle finger of your left hand two or three times, overlapping the beginning so that it's tight and doesn't fall off.
3. Similarly, wind the other end around the middle finger of your right hand, but don't stop: keep going until the entire length (minus about two inches) is wrapped around the right finger.
4. Hold your hands vertically in front of you and bend your middle, ring, and pinky fingers into your palm (as though you're about to say Bang! Bang!). Now, rotate your wrists away from you, causing your extended index fingers to pass under the string and end up pointing at the middle of your chest and keeping a half inch of string taut between the fingertips. This is the basic position for flossing one inter-dental space.
5. Insert both index fingers into your mouth, one in front and one behind the target. (When you get back past the bicuspids, it can be easier to use the thumb rather than the index finger on the anterior side.) Pull the string down between the teeth. This is where you find that that there's a good reason they make waxed floss. Mistake number two that I'd always made was to use unwaxed (I tend to a minimalist philosophy).
6. Move your fingers along the line of teeth in one direction, so that the string, rather than just being between them, is wrapped around the edge of the tooth, i.e., as much as possible, the string is pressed up against the front and back of the tooth. Now move the string up and down the surface, all the way down to the gum line. Don't worry about hitting the gum -- the edge of it is likely not sealed to the tooth, and it doesn't hurt to get between them.
7. Move your fingers the other way and repeat, doing the tooth on the other side of the gap.
8. Pull the string up out of the teeth and remove your fingers from your mouth and twirl your right middle finger to allow one loop of floss to unwind, and take up the slack with your left middle finger. You now have a clean area of string to use for the next inter-dental gap. Unless you've done them all, target the next one and continue from step 5. Otherwise, toss the string into the trash and rinse your mouth.

When you begin flossing after having slacked off for a while, you'll probably notice that your gums bleed. It won't be pouring out of your mouth sufficiently to irrigate your petunias, you'll just notice it when you spit. Unless you're slicing your gums open by drawing the string across them in a sawing motion, this is nothing to worry about, and will cease with regular practice.

Apart from the waxed/unwaxed question, the brand of dental floss that you buy (even if you're from West Virginia, you shouldn't use twine) makes a difference. (This discussion may be US-centric.) The "name" brands are Glide and some of the big toothpaste companies like Colgate. It may be that many people use Glide because the sample that they brought home from the dentist's office was that brand. Bzzzzzzt. The dentist gives you that because Glide is the only company that gives them free professional samples. Four out of five dentists surveyed[2] preferred another brand: Hi-Tech. The amazing thing is that this is generally the least expensive of the array of choices you'll see on the shelf; in fact, you may not see it at all, because the house brand (bearing the name of the grocery or drugstore chain) may well be Hi-Tech under the covers. This brand is slipperier, and when rubbed on the teeth, the cord unravels into several filaments which give you more cleaning action.

[1] The radioactive half-life of Samarium-145 is 340 days.

[2] I know of no actual survey; this is what my dentist told me.

I've always had trouble flossing

Okay, we all know we're supposed to floss. I don't really know how many people out there actually do, but I'm guessing a lot of people are like me. Whenever I go to the dentist and the hygienist cleans my teeth she says, you haven't been flossing, have you? And I say, No, but I'll do better from now on, I promise. That is typically the end of the conversation. I say I'll floss, and for a few days, or even weeks after the appointment, I do. Eventually, I get lazy, and stop flossing until my next appointment.

Until now…

I had my semi-annual dental appointment a couple of weeks ago and it was going pretty much like normal until…

Hygienist

Do you floss?

Me

You know, the thing is, I always floss for the first little bit after my last dental appointment, but then I slack off.

Hygienist

Oh really? Most people slack off except for the little bit before their appointment.

Me

Really?

Hygienist

Yeah, but even I slack off sometimes, and I know the consequences. I think the problem is we just pester people about flossing, but we don't explain why it's important

Me

Oh yeah? Why's that

Hygienist

Well, brushing is good for breaking up the food particles in your mouth and spreading the bacteria around. We all have bacteria, they're just part of our natural flora. However, when the bacteria are allowed to colonize, they form plaque.

Me

I see…

Hygienist

Once plaque forms, you can't break it up by brushing, it's just too strong. That's why we have to scrape it off when you come here. However, when bacteria colonize, they tend to do it below the gumline. Brushing won't get them, but if you floss, you can prevent the plaque from forming. Listerine is good too. Flossing is really the best way to prevent gum disease.

Me

I never knew that

Hygienist

Yeah, it's really the fault of us dental professionals not taking the time to explain it.

C-Dawg covered flossing procedure very well in his writeup, so how about some fun facts instead.

Floss Facts

• The area below the gumline is called the sulcus.
• People with periodontal disease are 1.5-2 times as likely to suffer a fatal heart attack and 3 times as likely to suffer a stroke.
• New studies show that diabetic patients with severe periodontitis have difficulty maintaining normal blood sugar levels.
• Infected oral tissues with pneumonia bacteria can be inhaled into the lungs where immune defenses fail to wipe them out.
• Mothers of prematurely born babies were 7 times more likely to have advanced periodontal disease than mothers whose babies were normal weight at birth.
• Individuals with artificial joints and heart valves are at an increased risk of suffering a serious infection when periodontal bacteria enter the bloodstream.

Sources

• http://www.floss.com/flossing.htm
• http://www.floss.com/hygiene.htm