How Important is Flossing?

Flossing made headlines last year for all the wrong reasons.  After the Departments of Agriculture and Health and Human Services, quietly dropped any mention of flossing in the latest dietary guidelines for Americans, flossing became a water cooler conversation topic.  The main reason for the change was because officials had never researched the effectiveness of regular flossing before making the recommendation to do so.

Whether there is any definitive research on flossing or not, it is hard to believe that self-evident  benefits of flossing are being overlooked.  If you floss regularly and skip a  few days you will notice that your gums will  bleed easily.  The bleeding is caused by inflammation of your gums secondary to plaque or tartar accumulation on your teeth. The dental term for inflammation of the gums is gingivitis.   In gingivitis your body is eliciting a local reaction in response to irritation caused by irritants.

Gingivitis, or inflammation of the gums, is a reversible first stage of gum disease.  If left untreated it will progress to periodontitis. The main difference between the two is that gingivitis is reversible if treated  appropriately while in with periodontitis there is permanent tissue destruction.  There are different levels of involvement in periodontitis.  From mild, where there is slight evidence of tissue destruction to severe, in which case there is very poor bone support for the teeth.  The disease can also be classified into an acute or chronic form.

There may also be other reasons why you should floss regularly.  A small gap between the teeth will create an area of food impaction. If you do not clean out that region and let the food and plaque sit undisturbed inflammation and  tissue destruction will be accelerated.  If possible the compromised area should be corrected with a restoration to prevent future problems.

The level of tissue destruction is also dependent on the host response to the irritant.  If two individuals have the same level of plaque accumulation, their bodies may respond differently to the irritation. Because of this, the amount of tissue destruction is not always consistent with local findings of irritants. Patients may have little plaque and more severe reaction and corresponding bone loss or heavy accumulation of plaque and tartar and little evidence of bone loss. Depending on the extent of involvement, tissue destruction due to periodontal disease is most evident by recession of the gum tissue, sensitivity of the teeth and increased mobility.

Severe cases of periodontal disease in individuals who brush but do not floss their teeth are uncommon.  However, not flossing can lead to periodontal disease.  Collectively, all the people flossing and the ones that do not, are ‘research subjects’ that  support the the theory behind a daily flossing routine.



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