Interdental cleaning, commonly known as flossing, is an often-neglected step in daily oral hygiene. Brushing cleans the broad surfaces of the teeth but fails to reach the tight spaces where teeth meet the gums. These inaccessible areas harbor oral bacteria and food particles. Neglecting flossing sets in motion a series of negative outcomes, beginning with localized irritation and potentially leading to serious health consequences.
The Immediate Consequences: Plaque and Early Inflammation
When the tight spaces between teeth are not cleaned, residual food debris and saliva quickly contribute to the formation of plaque, a sticky film of bacteria. This bacterial biofilm accumulates rapidly along the gumline and between the teeth. Within 24 to 72 hours, this soft plaque absorbs minerals from saliva and hardens into dental calculus, or tartar. Tartar cannot be removed by brushing or flossing alone.
The bacteria within the trapped plaque release toxins that irritate the gum tissue, causing an inflammatory response known as gingivitis. The gums become red, tender, and swollen, often bleeding easily during brushing or eating. This irritation is the body’s initial defense against the bacterial invasion.
A common consequence of this bacterial buildup is chronic bad breath, or halitosis. The trapped food particles and waste products from metabolizing bacteria generate sulfurous compounds, leading to an unpleasant odor. Gingivitis is the earliest and mildest form of gum disease. It is reversible by resuming consistent interdental cleaning and oral hygiene.
Progression to Tooth Decay and Cavities
As plaque remains undisturbed between teeth, the bacteria within this film metabolize sugars from the diet. This process produces acids that lower the pH level around the tooth surface. The acidic environment causes the demineralization of the tooth’s hard outer layer, the enamel.
The initial stage of tooth decay is mineral loss, which may appear as a white spot on the enamel. If acid erosion continues unchecked, the enamel structure breaks down, forming a cavity, or dental caries. These interproximal cavities, located between the teeth, are common when flossing is skipped.
Once decay penetrates the enamel and reaches the softer layer beneath, the dentin, the process can accelerate rapidly. Decay reaching the dentin, which contains microscopic tubes leading toward the tooth’s nerve, often causes sensitivity to hot, cold, or sweet stimuli. Professional intervention, such as a dental filling, is necessary to remove the decayed material and restore the tooth structure.
The Risk of Severe Gum Disease and Bone Loss
If gingivitis is ignored, the persistent inflammation can progress into a more severe condition called periodontitis. The body’s immune response to the chronic bacterial infection begins to break down the tissue and bone holding the teeth in place. The gums detach from the tooth surface, creating deepened spaces known as periodontal pockets. These pockets become sanctuaries for harmful bacteria.
In early periodontitis, minor bone loss and slight pocketing, often around four millimeters, may be observed. As the disease advances, bacteria and inflammation migrate down the tooth root, causing irreversible destruction of the alveolar bone. This breakdown of the supporting structures is known as bone resorption.
Moderate periodontitis is marked by pronounced gum recession, moderate bone loss, and pocket depths reaching five to six millimeters. Advanced stages involve severe bone loss, deep pockets of six to eight millimeters or more, and increased tooth mobility. This damage can lead to the shifting of teeth, difficulty chewing, and eventual tooth loss. Complex treatments, such as surgery or extractions, are often required.
The Connection to Overall Health
The inflammation associated with periodontitis is not confined solely to the mouth; it introduces a chronic, low-grade inflammatory burden to the entire body. Inflammatory mediators and bacteria from the infected gum tissue can enter the bloodstream, traveling to other organ systems. This systemic inflammation contributes to the development or exacerbation of various non-oral health issues.
Periodontitis has an established association with cardiovascular diseases, including an increased risk of stroke and atherosclerosis. The persistent inflammation may contribute to the hardening and narrowing of arteries. A strong bidirectional relationship also exists between severe gum disease and diabetes.
Periodontitis can make blood sugar control more difficult for individuals with diabetes, while poor glycemic control exacerbates the severity of gum disease. Addressing the chronic infection in the mouth supports the management of these and other systemic conditions. The presence of ongoing inflammation demonstrates that the mouth is an integral part of the body’s overall health.