Flossing

The American Dental Association recommends the regular use of dental floss in conjunction with toothbrushing to reduce the build up of dental plaque and prevent gingivitis. Dental floss is a string of fine filaments that is used to remove food debris and plaque from between the teeth and in other small areas that a toothbrush cannot effectively reach.

There are many different types of dental floss that are commonly available, including waxed and unwaxed monofilaments and multifilaments. Wax-coated monofilament floss does not fray when slid between the teeth, but it is generally more expensive than unwaxed or multifilament dental floss. Dental floss is also available in a broad array of widths; it is recommended that people choose their preferred width depending on the amount of space between the teeth, and depending on personal preference, as there is no one width that is better than any other. The small triangle of space immediately between the juncture of two teeth is known as the embrasure space, and the size of this space is helpful when determining the preferred width of floss of other cleaning aid. While studies indicate that there is no difference in the efficacy between waxed and unwaxed dental floss, some waxed floss is coated with either fluoride or antibacterial agents that may improve their effectiveness. Patients with mobility or dexterity concerns may prefer a supplemental device, like a floss threader or floss wand, to help them grip and manipulate floss and effectively reach the tight angles in certain parts of the mouth. While these flossing wands and threaders can help people reach the back teeth and may be easier to use, they also come with the risk of missing the area below the gum line while flossing.

Dental floss was invented in 1819 by Levi Spear Parmly, a New Orleans dentist. He recommended the use of waxed silk to dislodge debris trapped between the teeth and believed that this debris was the source of oral disease, and that flossing was the most valuable part of oral hygiene routines for disease prevention. In 1898, the first patent for dental floss was conferred to the Johnson & Johnson Corporation, which made dental floss from silk surgical thread. Like toothbrushing, flossing increased in popularity during World War II. Textile shortages combined with increased popularity led to the development of nylon dental floss, which eventually became preferable over silk because of its resistance to friction and its ease of production. By the 1970s, dental floss was a regular part of the daily oral hygiene routines of Americans.

The American Dental Association supports claims that flossing, when part of a hygiene routine that also includes brushing with fluoride toothpaste, can help prevent gingivitis as well as bad breath. Several studies have questioned the efficacy of flossing, but consensus finds that inconsistency in results are more likely to be related to personal flossing technique and motivation. For this reason, it is recommended that patients learn proper flossing techniques from their dental health professionals. Some dental health professionals recommend interdental brushes instead of flossing because of the potential technical inconsistency in flossing techniques. Patients who wear orthodontic appliances, like braces, may also require flossing aides or additional training to help reach beneath fixed appliances, as these fixed appliances can harbor and hide plaque buildup and adversely affect periodontal health.