What?! Is the sky falling? What dentist would dare utter such blasphemy!
Stick with me for a moment. You may learn something about flossing.
Here are the facts as I see them after more than twenty years in dental practice:
Most patients don’t floss. Most patients don’t like to floss. Most patients won’t floss even if you explain the benefits of flossing at every checkup visit for ten years. Most patients are convinced flossing makes their gums bleed and is uncomfortable to do. Most patients will tell you they floss, but “probably not as much as I should.” So really, why bother?
Another observation I have made about flossing regards what people think flossing is. I will sometimes hand a patient a piece of floss and ask them to show me how they floss. Without exception, I have seen patients pass the floss between their teeth and then pop it back out.
That sounds right, doesn’t it? Special effects department please sound the buzzer. That’s not flossing.
Add to this the fact that most patients will only perform this routine once in a while. If you call that “flossing” I say don’t lose sleep over the fact that you are not flossing regularly. That can be effective at pulling food out from in between your teeth, though, so feel free to do so. But if that’s not flossing, just what is it, really?
Flossing is the action of taking a length of floss – either the conventional “string” kind or pre-threaded on a fork-like device – and then passing it between your teeth while holding it in a “C-shape” against the side of the tooth. You then take the floss and rub the edge of the tooth, sliding it all the way under the gum-line in an up and down motion. How often can one do this? After every meal would not be too much. But if people did this at least once a day, the average case would see dramatic results after an average of two weeks of daily flossing.
If you haven’t been flossing regularly here is what you can expect: your gums will bleed when you start to floss. It is also likely to be a little uncomfortable at first. But over time, the bleeding should stop. If you haven’t had a dental checkup and cleaning for a while, it is a good idea to do so this first. Flossing against existing tartar will be an unending battle. Once the teeth are clean, however, daily flossing will usually result in pink, firm and healthy gums that don’t bleed. Other benefits? Fresher breath and reduced inflammation – which also means a lowered chance of heart attack and stroke.
If you only floss once in a while, though, inflamed gums will likely never get up to a point where the occasional activity makes any difference. So, if you don’t make it a discipline, why bother? But if you would like healthy teeth and gums for a lifetime, start flossing today!
When we are young our teeth make their way into our mouths through a process known as tooth eruption. How do they know when to stop erupting? Basically, they keep going until they find the opposing tooth. But what if we lose a tooth? Much like a computer program, the tooth opposite the missing one starts looking for the tooth that it is supposed to chew against. If it can’t find i
t, it may erupt all the way to the opposing gum. It’s not that the tooth is growing. The bone below (or above it) moves it into position. Of course, at this point, it’s in the wrong position, and entirely new problems often start to appear.
If this were all that happened, we would have enough to worry about in terms of our ability to chew our food well. This is important for good digestion and nutrition. Unfortunately, when teeth border an empty space they also have a tendency to try to drift into it. This means that teeth may drift forward or backward toward the spaces. Perhaps this is nature’s way of distributing the load now that one of the soldiers has fallen. It is an engineering marvel, but it can become a chewing nightmare.
While all of our teeth are important, structurally, the loss of certain teeth will bring about more change than the loss of others. Think of this in terms of the walls of your house. If you take down a non-supporting wall, the house will still stand. Take out a supporting wall, however, and you have a bigger problem. Teeth are constructed much like an arch, though. If you have ever seen a stone arch, you know it has a keystone at the top that keeps the arch together. Remove that one stone, and the whole thing collapses. In your dental arch, you can think of your canines as a keystone. Lose them, and the ensuing change is rapid. If your teeth were straight, they often won’t be for too much longer.
So, why then, do people lose teeth? The most common reasons that I see are:
Periodontal disease – this is sometimes also referred to as “gum disease” but is really a condition more directly affecting the bone. This is the result of a bacterial infection leading to the permanent breakdown of the bone surrounding the teeth. It is actually the most common form of tooth loss world-wide. Because it is generally not painful, often people have no idea that they have periodontal disease until their teeth start to get loose and fall out.
Tooth decay – this is what many people think is the main cause of tooth loss. And while it is true that tooth decay often does lead to tooth loss, it follows periodontal disease in terms of frequency.
Habits – this is the type of tooth loss that results from such things as tooth grinding or clenching. This area is one in which we often see a “domino-effect” of problems. Sometimes clenching or grinding starts with the loss of a single tooth or an accident resulting in a spinal misalignment. At other times, it may be due to stress, a deficiency, or genetic structural anomaly. In any of these cases, if the grinding or clenching results in the wear of your canines (those “key-stones” again), you may find yourself wearing down ALL of your teeth more rapidly. They are pointy for a reason. When you slide your teeth to the side, they are supposed to keep the back teeth from touching. If they wear down to the point where all of your teeth touch in all directions it is possible to wear them all down. Over the years I have had cases where what brought the patient in to see me in the first place was that they wore down their teeth to the point where they exposed their nerves. (Ouch!)
Accidents – this speaks for itself. And it happens. It may be a sports injury, car accident, a fight, or biting into something hard – but if it breaks off enough of the tooth, it can need to be extracted.
Whatever the cause, if you lose a tooth, you should speak with your dentist about replacement options. Together you can discuss the choices that are best for your circumstance. Where possible, try not to delay correcting your bite for too long. The additional changes that may occur with your bite over time can limit your choices or cost you more to correct. While a nice, straight smile may be desirable cosmetically, a good bite is also important for health and function.
Welcome!
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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