When did you last floss?

OSAN AIR BASE, Republic of Korea -- When was the last time you flossed? How often do you floss? Can you demonstrate how you floss? How many times have you heard these questions asked by your dentist? 
The response to these questions may be eyes rolling, a short hesitation debating the correct answer, an automatic yes without even hearing the question, or a no with some lame excuse why they cannot floss. No matter what your excuse may be, the situation will not get better if it is just being ignored. 

"I am surprised how many of my patients do not know the proper way to floss," said Capt. (Dr.) Ben Gantt, dentist with the 51st Dental Squadron. 

Why is it important to floss? The main reason is to reduce the amount of bacteria that live in your mouth. These bacteria feed on the food particles that are left in between your teeth. The bacteria will produce acid, which eat into the tooth's enamel creating cavities. Bad breath may also occur from the bacteria releasing sulfur compounds. 

The primary function of floss is to remove plaque, which is an invisible film of these bacteria. Plaque accumulates very quickly -- this is why we need you to floss daily. Therefore, if you do not floss, plaque remains in between teeth. It will eventually harden and turn into calculus/tartar. Unlike plaque, which can be easily removed by brushing, calculus can only be removed by a hygienist or a dentist. 

As time passes, more dangerous bacteria build up within the calculus. These bacteria produce toxins, which irritate and inflame the gums. This condition is known as gingivitis. The gums may turn red and bleed. If gingivitis is left untreated, it can progress into periodontal disease. Not only does this disease affect the gums, but the bacteria and toxins destroy the bone and structures that support the teeth. Therefore, this can lead to bone loss, loose teeth, and loss of teeth. 

What is the proper technique for flossing? First, use 18 inches of dental floss. Wrap the floss lightly around your middle fingers. Firmly grasp the dental floss with you index fingers. Then, form a C-shape around the tooth. Carefully slide the floss up and down between your tooth and gum line. Gently slide the floss in between both sides of your teeth and repeat until finished. Do not rush, one should take at least 2-3 minutes when flossing. 

Which type of floss is correct? There are two types of floss to choose from Nylon (multifilament) or PTFE (monofilament) floss. Nylon floss is available in waxed and unwaxed, and in a variety of flavors. Nylon floss is made of several strands of nylon. Therefore, it is more likely to shred with tight contacts. While PTFE floss is a single filament, it will be shred-resistant. However, it is more expensive. If you have limited dexterity, arthritis, or hate the idea of sticking your hands in your mouth, try dental floss holders or intra-dental cleaners. In the end, all floss products are great for removing plaque. 

For some people, flossing is not just for a healthy mouth, but for a healthy life. Here are a few interesting facts: 

-  People with periodontal disease are one and a half to two times as likely to suffer a fatal heart attack and three times as likely to suffer a stroke 

-  Diabetic patients with severe periodontitis have difficulty maintaining normal blood sugar levels 
-  Infected oral tissues with pneumonia bacteria can be inhaled into the lungs where immune defenses fail to wipe them out 

-  Mothers of prematurely born babies were seven times more likely to have advance periodontal disease than mothers whose babies were normal weight at birth 

-  Individuals with artificial joints and heart valves are at an increased risk of suffering a serious infection when periodontal bacteria enter the bloodstream 

Hopefully, this information will get the wheels turning, and the idea of flossing will be entertained. If you have more questions, do not hesitate to call the 51st Dental Squadron. Remember, a dentist wants a commitment from their patients to work for a healthier mouth -- a dentist can not do it alone. Our goal is to teach you the basics; therefore, you can replicate them on your own. So, at your next dental appointment, the dentist will not have to ask, "When was the last time you flossed?" They will be able to tell.