Asking For A Friend: Is flossing really that important?

You may not love the feeling of sliding thin string in between your teeth, but the experts say flossing is critical not only to oral health, but can also prevent serious diseases.

Karen Hawthorne 5 minute read May 13, 2022
Dental Hygiene - Flossing - Stock Illustration

Likely, if your gums bleed when you start flossing, it’s a sign you need to get into the habit of flossing regularly to deter destructive bacteria. GETTY

Dear Asking For a Friend,

I know flossing is part of good dental hygiene, but it makes my gums bleed, and frankly, I don’t like doing it. How necessary is it?

Signed, Sore Gums


Dear Sore Gums,

On the list of important things to do for your health — exercise, spend time in nature, cut out sugar, eat more veggies — it may feel like flossing your teeth is near the bottom. And if you end up with bleeding gums, that can make it even harder to make flossing a part of your daily hygiene routine.

But if you listen to your dentist, the scientific evidence that links poor oral health, like tooth loss or gum recession, with higher rates of cardiovascular problems is pretty powerful proof that cleaning in between your teeth is important.

In fact, studies reviewed by Lithuanian researchers in 2019 have also shown that gum disease, which is gingivitis in its early form and periodontitis when it really takes hold, is associated with rheumatoid arthritis, where your immune system mistakenly attacks your own body’s tissues. And a 2018 study published in the journal Gut demonstrated a link between this same bacterium, porphyromonas gingivalis, and pancreatic cancer.

7 out of 10 Canadians develop gum disease

Poor oral hygiene that allows plaque to form on your teeth, causing inflammation of the surrounding gum tissues. It can be relatively painless until pockets of infection form and start to destroy the gum tissue, putting you at risk of losing teeth. It’s a common problem, with seven out of every 10 Canadians developing gum disease at some point in their lives.

Dr. Aaron Burry, interim CEO of the Canadian Dental Association, is a practicing dentist in Ottawa, Ontario and former chief dental officer with Ottawa Public Health. He says brushing and flossing go hand-in-hand to keeping you healthy.

“Flossing is just as important as brushing, from the perspective of being able to remove what gets in between our teeth which the brush leaves behind,” he says. “When we leave particles in between our teeth, it gives the bacteria basically a food source, which allows them to grow and develop in the gums.”

The bleeding and swelling is the body’s natural inflammatory response to protect you from the toxins and chemicals produced by the bacteria, Burry explains.

Likely, if your gums bleed when you start flossing, it’s a sign you need to get into the habit of flossing regularly to deter destructive bacteria. Regular flossing is once a day or every 24 hours.

“It takes about 24 hours for the bacteria underneath the gum to really get a hold,” he says. “Flossing does two things: it mechanically removes it, but it also puts some degree of air or oxygen in the area. Many of the bacteria that are under the gum don’t like oxygen and they tend to be the least-healthy type of bacteria. It’s another way of controlling the bacterial composition and keeping healthy.”

The other danger of not removing bacteria with the two-punch brushing and flossing is they produce acids that weaken the enamel in between the teeth. “What happens over time is you have constant acid exposure. The weakness means bacteria can find a way into the tooth, which is the beginning of a cavity,” Burry says.

His dad was a dentist who would line up the family for inspection to make sure teeth were properly cleaned. “I know my dad was, I would say, somewhat traumatized by the number of kids he saw with tremendous cavities,” he says.

Burry is committed to brushing regularly and flosses, “pretty much every day, to stay ahead of the game.”

Flossing technique

His tip for reluctant flossers is to start with one or two teeth a day to master the technique and then gradually add more teeth as you become more comfortable. But technique can be tricky.

It’s not just inserting the thread in between the teeth and pushing it out. Wrap the floss around the tooth and then slide it up and down gently on the tooth surface. Every time you push it between two teeth, you have to remember that both teeth need to be cleaned.

And if your teeth are tight together, there are floss options with wax and other coatings and custom thicknesses for comfort. There are also the popular floss holders — the small plastic instruments with a short handle so you can reach the area with one hand.

“If you can’t floss, the other option, based on the research, is to look at rinsing and to make sure that you have a solid rinsing regime and that you have a very effective brushing regime,” he says.

That means mouthwash and looking into irrigation devices that can push fluids through the teeth. These devices come very close to what flossing can do — Burry recommends talking to your best resource, your dentist, to get advice.

The takeaway: “If you can master flossing, that’s really the goal. Once you start flossing, it just becomes easier.”

Karen Hawthorne is a Toronto-based writer.
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