Dental professionals maintain a clear consensus that daily interdental cleaning, including flossing, is necessary. The American Dental Association (ADA) recommends performing this practice at least once every day. This daily routine is fundamental for disrupting the continuous cycle of bacterial accumulation in the mouth. Skipping this step leaves a significant portion of the tooth surface uncleaned, creating an environment where oral diseases can easily develop.
The Biological Necessity of Interdental Cleaning
The need for cleaning between teeth is rooted in the biology of plaque, a sticky, colorless biofilm that constantly forms on teeth. This film consists primarily of organized colonies of bacteria embedded in a matrix. The initial bacterial cells begin to colonize the tooth surface within minutes of brushing. If left undisturbed, the entire plaque layer can return to its original volume within 12 to 24 hours.
Brushing is effective for cleaning the broad, flat, and chewing surfaces of the teeth, but it is physically unable to reach the entire structure. Toothbrush bristles typically miss the tight, concave spaces where two teeth meet and the area just beneath the gumline. Experts estimate that brushing alone cleans only about 60% of the tooth’s total surface area. This leaves the remaining 40% vulnerable to bacterial attack.
This inaccessible 40% is where bacteria thrive, forming a mature biofilm that leads to dental problems. If this biofilm is not mechanically removed daily, it begins to mineralize, hardening into calculus or tartar. Tartar is porous and rough, providing an ideal anchor for more plaque. Since tartar can only be removed by a professional dental cleaning, daily disruption of the soft plaque is so important.
Health Implications of Skipping Daily Flossing
Failure to disrupt the plaque biofilm between the teeth leads directly to a series of negative health outcomes, beginning with inflammation. The toxins and bacterial debris released by the plaque induce an immune response known as gingivitis, the earliest stage of gum disease. Gingivitis is characterized by gums that are red, swollen, and prone to bleeding, signaling that the body is fighting an infection.
Fortunately, gingivitis is reversible with diligent oral hygiene, including daily interdental cleaning. If the inflammation is allowed to persist, the disease progresses into the more severe form known as periodontitis. This occurs when the bacterial infection spreads deeper, causing the gums to separate from the teeth and forming infected pockets.
In periodontitis, the body’s chronic inflammatory response begins to break down the connective tissue and the alveolar bone that holds the teeth. This destruction of supporting structures is irreversible and can ultimately lead to tooth loosening, shifting, and eventual tooth loss. The inflammation and bacterial pathogens associated with periodontitis also link to health issues elsewhere in the body.
Periodontal disease is associated with systemic conditions, though a direct cause-and-effect relationship is still being investigated. The chronic oral inflammation is thought to increase inflammatory markers in the bloodstream, contributing to conditions like cardiovascular disease. Furthermore, bacteria from the mouth can enter the bloodstream, potentially affecting conditions like diabetes management.
Practical Guide to Effective Flossing and Alternatives
Maintaining the daily habit of cleaning between teeth is crucial. The recommendation is to choose a method that can be performed consistently and correctly. Traditional string flossing remains a highly effective method for scraping sticky plaque directly off the tooth surfaces. The proper technique involves using approximately 18 inches of floss, winding most of it around the middle fingers, and holding a small section taut between the thumbs and index fingers.
When inserting the floss, use a gentle, back-and-forth motion to avoid snapping it onto the gums. Once the floss is between the teeth, curve it into a “C” shape against one tooth. Gently rub the floss up and down, including slightly beneath the gumline. This C-shape technique ensures the floss wraps around the curved surface of the tooth before repeating the process on the adjacent tooth.
For individuals who find string flossing difficult, such as those with braces, dental implants, or limited dexterity, several alternatives exist. Interdental brushes, which resemble tiny pipe cleaners, are effective for cleaning larger gaps between teeth. Water flossers, or oral irrigators, use a pulsating stream of pressurized water to flush out debris and plaque.
Studies suggest that water flossers can be effective at reducing gingivitis and bleeding gums, and they may be easier to use around complex dental work. While string floss excels at the scraping action necessary for plaque removal, the most important factor is using an interdental cleaner once a day. The best tool is the one that you will use correctly and regularly to keep the interdental spaces clean.