Some Common Questions About Flossing

Quite often we are faced by numerous questions about flossing. Some of the common queries can be summarized as follows:

1. When should I start flossing?

Ans: When you get the permanent teeth. These teeth are not as spaced as the baby teeth. Therefore, brushing alone is not enough. It does not scrub the surfaces of the teeth that rest against each other. You have to pass a piece of floss to clean out those surfaces. If you don't, then you will get 2 cavities (i.e., two teeth will get decayed) for every space that retains the food particles. If your child has teeth that touch each other or in other words, have no gaps in between, you can floss only in those areas to reduce the risk of getting cavities, even if those are the deciduous teeth. In the beginning, we usually ask the parents to help the children floss their teeth.

2. When should I floss. Before or after brushing?

Ans: The most important thing is that you floss. You can decide to floss before brushing. But you will run the risk of pushing the smaller food particles back into the crevices as you brush (that is my personal feeling. I am not aware of any research that has been conducted on this issue). So, my advice will be to brush and then floss. You'll be amazed to see what comes out! You can rinse afterward. You can also floss, rinse and brush. I guess, it depends on your personal preference.

3. I have bone loss and flossing does not help . What can I do?

Ans : When you have bone loss and as a result have already lost the inter-dental papillae (the gingival tissue between the teeth), you can switch to a thicker type of floss (Some products are marketed as Periodontal Floss). This is a yarn-like material. As soon as you stretch it the piece becomes thin, you put it in and let go. It will coil up, become thick, wrap against the surfaces better and perform more effective cleaning.

If you have periodontal disease with moderate to severe bone loss, flossing with a thin piece of floss may not be enough. In that case, you may want to use a Proxy-brush. It comes with a small bottle-brush-like tip and a handle. You should hold it perpendicular to the gap and use an in-and-out motion. The bristles will clean the exposed root surfaces better. This can be used in combination with a rubber cone stimulator.

4. My 'gums' are tender and they bleed. So, I don't floss or brush in that area. Is that okay?

Ans: As soon as you get tenderness and bleeding from the gingiva (gum), you know you have gingivitis (inflammation of the gingival tissue). You cannot stop brushing or flossing in that area. It is like a bad cycle of events. The more you avoid cleaning, the more you will have the accumulation of germs and inflammatory substances in that area making the condition worse. So, even if it hurts a little bit in the beginning, you have to keep on brushing and flossing as you're supposed to. The signs of inflammation should disappear within a week or so, leaving the tissue healthy and not tender.

Note : If you do not take care of the condition at this early stage, this can lead to Periodontal Disease with marked bone loss.

5. I do not floss because it gets caught. My teeth are arranged so tightly that th floss rips. What should I do?

Ans: First of all, you can switch to the waxed type of floss. That will glide easily into the area. If that doesn't work, you can choose the floss that is designed like tape (flat kind). That will conform better to the narrower gaps.

Note : When you already have bone loss or slightly larger gaps between your teeth, you will be better off using the "Periodontal Floss" ( available at any pharmacy ), because that will cover more surface area. Just wiggling a narrow piece of floss in a bigger gap does not do the job effectively.