Family Dentist Files: Brush then Floss OR Floss then Brush?

Dr. Kyle Hornby

Patients are committed to the health of their teeth and gums, and for good reason. Mounting research shows a link between oral health and overall health. Specifically, plaque and bacterial contaminants can enter the bloodstream through the gums. This can cause bacterial deposits in blood vessels and arteries while also affecting success of prosthetic joints and heart valves. Ask your Kitchener Family Dentist for more details about how your oral health is intertwined with overall well being.

What does flossing do?

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Flossing cleans areas of your teeth and gums that cannot be reached by your toothbrush bristles. Therefore, if you don't floss there are entire surfaces of your teeth that are never being cleaned. In fact, the Canadian Dental Association (CDA) suggests that, without flossing, more than 30% of your tooth surface goes uncleaned.

Flossing removes plaque and bacteria buildup at the contact point between neighboring teeth. Flossing also cleans the open spaces between teeth where larger pieces of food can accumulate. Lastly, flossing allows you to clean your gum pockets thoroughly to stave off Gingivitis and Periodontitis (or "gum disease"). Ask your Family Dentist or Hygienist to provide a demonstration on proper flossing technique.

Flossing: What do the experts recommend?

To answer this question, let's take a look at what the Canadian Dental Association (CDA) and American Dental Association (ADA) recommend. The CDA recommends that you floss before brushing your teeth. In line with this, the ADA suggests that flossing before brushing allows the fluoride in your toothpaste to have contact with more of your tooth surface. That is, if you remove the plaque layer from the surfaces in between your teeth, they won't interfere with fluoride contact. Given that Fluoride makes your tooth enamel resistant to acid dissolution and decay, the extra fluoride activity is critically important!

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As a Family Dentist, I have one main concern with flossing prior to brushing. It becomes more likely to push plaque and bacteria back into sites between the teeth. What I recommend to patients is this:

  1. Lateral Flossing Movement. When I ask my patients to demonstrate their flossing technique to me, they commonly floss between teeth up-and-down. There is no side-to-side movement. When you incorporate lateral movement while flossing between the teeth, you will notice more plaque and food debris coming out of the space. I can promise you this.
  2. Make Multiple Trips! Floss into and out of the same space at least twice. You will notice more food debris coming out this way.
  3. Rinse! If you rinse and spit, you are likely to evacuate most or all of what you have flossed out. Rinsing and spitting prior to brushing gets the plaque and debris you have disrupted with flossing out of your mouth. Now, you are ready to brush without the risk of pushing these irritants back in between teeth.

Don't hesitate to ask your Family Dentist for recommendations regarding flossing technique!

Flossing: What Happens if You Don't Do It?

It is recommended that you floss at least once daily. To get the most "bang for your buck", floss before bedtime. When you do this in conjunction with thorough nighttime brushing, you are removing all irritants from the oral cavity for 8-10 hours while you sleep. This gives you 8-10 hours of regeneration time for your gums, and RE-mineralization time for your teeth!

On the opposite side of the same coin, when you don't floss, plaque, food debris and other irritants accumulate on teeth and gums continuously. At nighttime, you are allowing these irritants to stagnate for 8-10 hours. This leads to tooth DE-mineralization and decay. It also leads to chronic gum inflammmation. Additionally, if plaque is left for 1-2 days without removal, it mineralizes and becomes tartar. Tartar is far more difficult to remove compared to soft plaque. If you are still unclear about all the benefits of flossing, ask your Family Dentist for a rundown!

A Special Note on Flossing From Your Kitchener Family Dentist: Kids

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Children and teens tend to have the highest frequency of decay as a result of not flossing. Baby teeth are covered with an extremely thin layer of enamel. As a result, they are highly susceptible to tooth decay if flossing is neglected. Even in teenagers, who have a full complement of adult teeth, a lack of flossing can lead to cavities. My recommendation is that adults floss with their children and young teens to reinforce the habit. Show them how to do it properly and they will carry that habit with them for a lifetime!

Proper Flossing Technique

Here's the recommended flossing technique straight from the Canadian Dental Association:

  1. Take a length of floss equal to the distance from your hand to your shoulder. Wrap it around your index and middle fingers, leaving about two inches between your hands.
  2. Slide the floss between your teeth and wrap it into a "C" shape around the base of the tooth and gently under the gumline. Wipe the tooth from base to tip 2 - 3 times.
  3. Be sure to floss both sides of every tooth. Don't forget the backs of your last molars.
  4. Move to a new section of the floss as it wears and picks up particles.

If you don't floss, or floss infrequently, you may notice that your gums bleed during flossing. This is normal and due to inflammation. After 1-2 weeks, you will notice that your gums become less red, less puffy, and less prone to bleeding. This is evidence that your gums are becoming significantly more healthy.

If you have questions about your oral health or home care routine, give us a call at (519) 576-8160 or request a consult here.

Written by Dr. Kyle Hornby, Kitchener Family Dentist

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your Dentist in Kitchener or other qualified healthcare provider with any questions you may have regarding a dental condition or treatment.

Enjoy a fresh start.
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