Common sense. Does it seem to you that this has become a rare commodity nowadays? Possibly, then, it is really uncommon sense that we should be talking about.
The latest example of an affront to logic – at least for me – lies in the latest media challenge to oral health. This morning various news agencies including The New York Times, suggested that maybe flossing is really overrated. Apparently, “officials” have never researched the effectiveness of regular flossing.
Now, millions of people are likely to jump on this as a justification for not flossing. But, in reality, the new media sensation is probably not going to change very much at the end of the day. Why? Because I can confidently tell you – based on more than 25-years of personal experience – most people don’t floss anyway. About all this latest “research” will promote is the possibility that some people will feel just a little less guilty about what others with any sense (common or uncommon) already understand is a pretty good idea.
But, it makes for good press. Doesn’t it?
Just for the sake of argument, let’s assume that flossing doesn’t remove plaque. Heck. Some people fail to remove plaque with a toothbrush. That doesn’t mean either fails to benefit the patient, if done properly. I can think of several reasons why flossing helps, though:
Passing floss between the teeth sweeps out the contact point between them – meaning the points where they touch. That’s a source of about 30% of all tooth decay. Your toothbrush typically doesn’t reach those areas, unless you have gaps between your teeth. Floss does reach those areas.
Flossing stimulates blood flow in the gums. One of the body’s first-line mechanisms of defense is to increase blood flow to an affected area. You are effectively helping your body do this in a controlled manner by flossing.
A number of the bacteria under your gums are anaerobic bacteria. That means they don’t grow in room air. So what is a person introducing into the gum pocket when they pull back their gums by flossing? Could it be . . . air? Is it possible that the oxygen in the air could kill some of those bacteria as well?
Think about it.
If we can set aside this newly created question of doubt for just a moment, I would propose that you ask yourself the following question:
“Have I ever flossed consistently?”
By this, I mean every day, and it would have to have included doing so for at least two weeks.
This question is particularly directed to someone if they ever had a gum problem like gingivitis or periodontal disease. Sure, one needs to get rid of tartar and control bacteria as well, but for patients that make the effort to floss (and with only a few qualifications that I can think of), it is almost a sure bet that their gums got better as a result of the daily exercise. First of all, the gums probably bled less afterward. Not in the beginning – to be sure – but after about two weeks of flossing every day, we typically see positive change. Breath improves too. An overall sense of well-being is not out of the question either.
When it comes to flossing sporadically, I agree. It doesn’t help much. It’s kind of like exercising once or twice a month. And let’s face it, that’s where most of the population lives when it comes to flossing — once in a blue moon. Is regular exercise effective, though? What does your common sense tell you?
Why would I hold on to this idea in the face of “new evidence”? Well, I have seen flossing help too many times to just call it a coincidence. Hard core scientists might say “Oh, well, that’s just anecdotal evidence. It doesn’t stand up to real scientific scrutiny.” OK. Then survey practicing dentists. Let’s see if I’m the only one with that observation and experience. I doubt it.
I’m not saying flossing is the only thing you need to do to have healthy gums. It isn’t. Diet and good nutrition are paramount. A healthy immune system doesn’t hurt either. But for Pete’s sake, flossing is cheap, really not all that hard to do once you have practiced it for a while, and it can end up saving you a lot of money in the long run. With health care costs being what they are, I can’t think of too many actions a person can take that bear as much fruit and keep money in their pockets.
But, if the media has just succeeded in making you feel better about not flossing, then OK. Bully for them. (Heaven knows, they do a top notch job spending most of their time getting people to feel less than great.)
And, I suppose there are other ways to handle tooth loss – which, by the way, happens a lot more from gum disease than tooth decay.
The posting below is actually taken from our Weird Dental “Facts” section. It’s an assortment of dental trivia and facts — some true, some we’re not so sure about 😉 — but either way, we hope to entertain, as well as educate you, with our postings.
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This dental fact was prompted by a recent television program I watched that discussed three of the top life-threatening emergencies. We hope you never find yourself confronting this type of problem, so here is the Weird Dental “Fact”:
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A dental infection can kill you.
Weird?
Perhaps.
But also true.
A toothache left untreated can, over time, develop an abscess. (An abscess is an infection that fills with pus and debris.)
Periodontal disease, left untreated, can also develop an abscess over time.
The trouble with many dental problems, though, is that in their early stages they are seldom painful.
In fact, sometimes, they aren’t painful even after they become more advanced. So people tend to put off treating cavities and gum disease hoping it will just go away or get better on its own. Then, when it does get worse, they will often put that off as well This is where it can get really dangerous.
One complication of a dental infection is called Ludwig’s Angina. It’s a type of infection that can travel from the roots of the teeth to the floor of the mouth and under the tongue. The infection can spread very quickly, creating a swelling that can block your airway or prevent you from swallowing. This can be life-threatening.
It can be cured with quick treatment that gets the airway open and with antibiotics, but sometimes surgical intervention is also necessary.
The better solution is to never let your oral health become so neglected as to allow the possibility of this type of infection.
Lasers are familiar to many of us from science fiction (think of the Star Wars light saber) to comedy (remember Austin Powers’ Dr. Evil?). The fact is that lasers surround us in every-day life. For example, in the home you will find them in CD players, while industry uses them for high-speed metal cutting machines and measuring devices. Hair replacement, tattoo removal, dermatologists, eye surgeons — they all use lasers.
So do dentists. And so does our office.
This begs the question, just what is a laser? How is it different from any other kind of light? “If Dr. Evil planned to destroy the world with one, why won’t it hurt me when you use it on my gums?!” Actually, that’s three questions . . . .
Anyway, let’s try take them in order:
The word “LASER” itself is an acronym that stands for light amplification by stimulated emission of radiation. This concisely describes exactly how a laser works. The laser is a device which controls the way that energized atoms release photons (a quantum of electromagnetic energy). When we say “radiation” however, we are not talking about ionizing radiation — such as would be produced by an x-ray.
Laser light is very different from normal light or radiation emitted by an x-ray. Laser light has the following properties:
The light released is monochromatic. It contains one specific wavelength of light (one specific color). The wavelength of light is determined by the amount of energy released when the electron drops to a lower orbit.
The light released is coherent. It is “organized” — each photon moves in step with the others. This means that all of the photons have wave fronts that launch in unison.
The light is very directional. A laser light has a collimated (very tight) beam. This makes it stronger and concentrated. A flashlight, on the other hand, releases light in many directions, and the light is very weak and diffuse.
Why won’t it burn you to a crisp when we use it on your gums? Clearly, we’re using a controlled power setting (in our office we use a diode laser) — in fact, most patients tell us they don’t feel anything when we use it in conjunction with their dental cleanings. But that doesn’t mean it isn’t effective!
Watch the video below for a demonstration and explanation of how a dental laser is being used during a routine cleaning.
If you would like to read more about how we use a dental laser in our office and how it can benefit your health, check out the following article posted in the Services section of our website:
There are a number of factors that can contribute to the formation of dental cavities. One fundamental that will apply to most everyone concerns the reduction of dental plaque. If you want fewer cavities, reduce your plaque levels.
Dental plaque can be defined as a complex microbial community, with greater than 10 to the 10th power bacteria per milligram. (That’s really a lot of bacteria.) Just to keep things simple, though, the problem is that these bacteria produce acids on your teeth – and the acids dissolve the enamel, leading to tooth decay.
After only a few years of practice, it became obvious to me that most people have difficulty identifying plaque. Even now, I’ll begin a dental exam or cleaning on a person and start removing large areas of plaque. If I casually ask the patient about their cleaning regimen, often I’m told “I brushed just before I came in here!”
Since that much plaque can’t form in an hour, the obvious conclusion is that the patient missed it or simply doesn’t see it. Just to be clear, plaque is the soft, sticky film that occurs on the surface of teeth – not the hard substance your dentist or hygienist has to pick away, which is tartar. Though it is basically mineralized plaque, virtually no amount of tooth brushing and flossing will remove tartar after the fact (dentists call it ‘calculus’). Once formed, calculus needs to be removed at your office visit.
It is useful to know that if you control your plaque well, calculus won’t be much of a problem. So let’s focus on that for a moment. What do you do if you feel you are brushing, but the dentist tells you he still sees plaque? Stain it!
Lately, I have been seeing more commercials advertising products for children that stain their teeth blue after they have rinsed with it. The child then brushes until all of the blue stain has been removed. What the liquid is staining is plaque. I think this is a great way to simplify the process of identifying the problem. Whether you are six or sixty, the principle is the same.
If you want to be certain you have gotten the plaque off, rinse with the stain after each meal and then brush (and floss) until you have removed the discolored areas. Barring other systemic or external contributory factors (such as medications leading to a dry mouth), you and your dentist should see a big improvement in the cleanliness of your mouth, and fewer cavities over time!
Here is an interesting exchange I had with a patient not too long ago. I’m getting ready to start a cleaning after completing my examination. His gums are red (he has gingivitis), there is plaque visible, and I just know those gums will bleed when I start to clean them. I’d like to help him get this under control, but I suspect he doesn’t floss, so I ask “Do you floss?”
His answer: “Whenever I need to.”
I’m thinking: “That would be, like, EVERY DAY.” But instead I ask: “How often is that?”
He replies: “Whenever food becomes noticeably stuck between my teeth.”
I’m actually detecting just a little annoyance now, and then he says: “Yeah, every dentist I have ever been to mentions the flossing thing.”
Well, I suppose I could talk about his favorite color, or maybe something equally inane, like the weather — but somehow the ‘flossing thing’ seemed appropriate. And then it occurred to me, maybe that IS “flossing” for this guy. And how many others, I wondered?
Therefore, in my quest to help rid the world of gingivitis and periodontal disease, (which just may be the shared goal of “every other dentist” who has recommended flossing) I’d like to clarify a few points about what it is and what it isn’t. While floss is unquestionably effective at removing food particles from between your teeth, just picking out the occasional chunk of steak from between your teeth doesn’t classify as “flossing.”
Flossing involves taking a piece of floss – say, about eighteen inches or so – grasping it between your thumb and index finger (just a few inches apart), then holding it in a “C” shape against the side of your tooth. Pre-threaded flossers are just fine in my opinion. Use whatever you are most comfortable with and whatever will get you to floss regularly. Rub the floss up and down the sides of every tooth. You actually want to slide the floss under the gum line. This cleans out areas your toothbrush cannot effectively reach.
Imagine not cleaning some parts of your teeth – ever. Or maybe, you just clean some teeth and not others. Do you think the unclean teeth might become more subject to tooth decay? If you answered “Yes!” then you would be right. This is exactly what occurs when you don’t floss. The parts of the teeth that are in contact with each other never get brushed. It’s not physically possible. So, a sizeable portion of all the fillings I end up having to place for patients are between the teeth. This is so easily helped . . . floss!
If you are just beginning to floss, you can expect your gums to bleed. Don’t let this ‘freak you out.’ A number of patients have said to me over the years “I tried flossing but it made my gums bleed, so I quit.” No. Bacteria, gingivitis, and nutritional deficiencies made your gums bleed. Flossing will help. You just need to stick with it until you notice less and less bleeding.
It is important to have your teeth and gums examined regularly. While gingivitis and periodontal disease are bad enough, there are a few even more serious conditions that could contribute to bleeding gums.
I actually could go on for quite a while about the many benefits to your overall health that flossing brings, but I’ll spare you for now. Or shall we just talk about the weather?
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.
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