Most people focus on brushing, a habit that cleans the easily accessible outer, inner, and chewing surfaces of the teeth. However, a toothbrush cannot effectively reach the tight spaces where adjacent teeth touch, leaving a significant portion of the mouth uncleaned. Flossing addresses this deficit, removing plaque and food debris from the interdental space, which accounts for up to 35% to 40% of the entire tooth surface area. When this routine step is skipped, the consequences begin immediately, affecting oral health and general well-being.
Immediate Buildup and Halitosis
The most immediate consequence of neglecting to clean between teeth is the rapid accumulation of dental plaque, a sticky biofilm composed of bacteria, food particles, and saliva. If not mechanically removed by flossing, the plaque can start to harden into calculus, or tartar, which requires a professional cleaning.
These bacteria, especially those feeding on trapped food remnants, produce waste products in the form of volatile sulfur compounds (VSCs). VSCs are the primary culprits behind halitosis. The odor persists because the source of the VSCs—the trapped plaque and food—remains lodged between the teeth, unaffected by brushing or mouthwash. Regular flossing is the only way to physically dislodge this material and eliminate the source of the unpleasant odor.
The Onset of Gum Inflammation
Plaque accumulation along the gumline and in the interdental spaces triggers a localized immune response. This reaction is the first stage of gum disease, known as gingivitis, which manifests as inflammation of the gingiva. Symptoms include redness, swelling, and tenderness of the gums, which may bleed easily when brushing or flossing.
The continuous presence of plaque sustains the irritation. The condition is generally considered reversible because the inflammation is confined to the soft gum tissue, without damage to the underlying bone or connective tissue. With timely intervention, involving consistent flossing and professional cleaning, the gums can return to a healthy state. If the plaque is not removed, this initial inflammation progresses to a more serious disease.
Interproximal Tooth Decay
The trapped plaque in the tight contact points between teeth creates a localized acidic environment that directly attacks the hard tooth structure. Bacteria within the plaque metabolize sugars from the diet, releasing acids that demineralize the enamel and dentin on the sides of the teeth. This process leads to interproximal caries, or cavities that form between adjacent teeth.
These hidden cavities are difficult to detect visually during a routine check-up. They often progress silently, reaching the sensitive dentin layer before causing any noticeable pain or sensitivity. Dentists must rely on specialized tools like bitewing X-rays to spot this decay early. If left untreated, interproximal decay can necessitate more involved procedures such as root canals or tooth extraction.
Advanced Disease and Systemic Health
When gingivitis is ignored, the chronic inflammation can progress into periodontitis, which involves irreversible damage to the tooth’s supporting structures. The sustained bacterial infection and the body’s immune response begin to destroy the periodontal ligament and the alveolar bone that anchors the teeth. This destruction leads to the formation of periodontal pockets, deeper spaces between the gum and tooth root where more bacteria can colonize, creating a self-perpetuating cycle of disease.
The eventual outcome of untreated periodontitis includes gum recession, increased tooth mobility, and ultimately, tooth loss. The chronic, low-grade inflammation associated with advanced gum disease does not remain localized to the mouth. Periodontitis is linked to a higher risk or complication of several systemic health issues, including cardiovascular disease and type 2 diabetes. The inflammatory mediators and bacteria originating in the infected gums can enter the bloodstream, contributing to systemic inflammation and potentially exacerbating conditions like atherosclerosis and making blood sugar control more challenging for those with diabetes.