When you consider health priorities for your family, does dental flossing even make the list? It’s more foundational to overall health than you may realize.
The American Dental Association (ADA) recommends brushing two times daily for at least two minutes each time as the first step in keeping your teeth and gums healthy. But even the most advanced electric toothbrush can’t fully cleanse the spaces between your teeth. That’s why the ADA also advises that you floss once a day to remove hidden food particles and plaque—the sticky film coating your teeth—that can lead to cavities and periodontal/gum disease.
We asked a local dental health specialist—and father of three—for further advice. Dr. Peter Maragos, D.D.S., M.S.D. owns a family periodontal practice in Brunswick, serving patients in Cuyahoga and Medina counties since 2000. Periodontists treat gum disease and other conditions affecting the gum tissues that surround and support the teeth, and the underlying jawbone, which anchors teeth in place.
He says, “Most periodontal disease occurs between the teeth because that’s where the tight spots are. When we’re brushing our teeth, we’re only hitting the surface of the tooth. The only way to get in between, in those gaps and crevices, is with flossing.”
Periodontal disease is a progressive condition that begins with mild gum inflammation called gingivitis (the leading cause of tooth loss in adults in the developed world). Signals of periodontal disease include red, swollen, painful or bleeding gums.
It all begins when the bacteria living in plaque multiply and cause an infection in the surrounding tissues of the teeth, causing them to become painfully irritated. Eventually, this infection can cause the jawbone to recede and the teeth to become loose.
Maragos explains, “The main cause of periodontal disease is the plaque and tartar buildup on the teeth. Plaque is a very sticky film composed of bacteria. It forms from the sugars and starches in your food that interact with the bacteria in your mouth. If the soft plaque stays there long enough, it becomes tartar, which is harder to remove. The main problem is not getting to the plaque in time. Once it becomes tartar, it’s a main cause of periodontal disease.”
“It can lead to tooth loss, gum infections, periodontal disease, disease surrounding the bone, and even chronic health conditions, including heart disease… Only floss can remove the bacteria in the plaque and tartar between the teeth,” Maragos says.
He stresses that dental hygiene is an effective defense against periodontal tooth loss. It involves not just brushing, but flossing and regular dental checkups. “You can’t just rinse with mouthwashes, power brushes or Waterpiks. These are all nice adjuncts but they cannot take the place of dental floss. Flossing is very important to optimize your oral health.”
Dr. Maragos offers these top tips for families:
Tip #1 – Show Kids How
When flossing, use an up-and-down motion (not a sawing motion) between teeth. Once you’re in the gap, angle the floss toward the right with an up-and-down motion, then bring it back up from the pocket area and curve the floss around the left side of the tooth, again with an up-and-down motion. So you’re flossing two sides each time you floss between teeth.
Tip #2 – Start Early
It’s challenging to encourage children to incorporate good oral home care into their daily routines, so set expectations early on. Brush your child’s teeth from the time they erupt until your child is about 2 years old. Then they should be encouraged to brush their own teeth. The ADA recommends starting flossing once your child’s teeth are making side-by-side contact with each other (the previous gaps have closed). This will lead to excellent independent home care as children gain hand dexterity and control, Maragos says.
Tip #3 – Make it a Family Affair
“Kids will be very compliant if they see their parent doing it; especially if they do it together,” Maragos says. “Establish that this is something we do together every night and every morning.”
Tip #4 – Find the Fun
Put on some music to play for the two minutes of brushing and then another song for flossing. To encourage correct oral hygiene, you can encourage your toddler to brush and floss on their favorite teddy bear or doll. There are also read-aloud books about dental care you can enjoy together.
“As parents, we encouraged good oral hygiene with our kids by making it fun for them,” Maragos says. “My wife is a hygienist; she would sing to them and make the process a game.”
Tip #5 – Give Them Choices
Ask “What color/theme of toothbrush do you want? What toothpaste flavor do you like?” Just ensure the toothbrush bristles are soft and the toothpaste is approved by the ADA with the recommended amount of fluoride for your child.
And let them pick their floss. While regular floss offers better control and flexibility to get into the pocket areas, other floss threaders with handles—dental picks, tiny brushes, or water flossers—are also effective.
Maragos adds, “The fun flossers are a good start to get used to cleaning in between the teeth, but by age 5-6, their dexterity is better and they should be able to get regular floss around their teeth, especially if their parent is right there, encouraging them along.”
Tip #6 – Adapt Your Approach for Teens
Teenagers may be tempted to neglect oral hygiene routines. So you need to change your motivational strategy and appeal to social cues.
“Teens are always worried about their breath,” Maragos says. “Bad breath comes from bacteria on the tongue and gum tissues. Brushing, flossing, and using mouthwash kill the bacteria that cause bad breath, resulting in fresh breath.”
While you may want to avoid a confrontation about flossing, he adds that he has noticed more periodontal problems among younger patients over his 25-year career.
“I don’t know if it has to do with their oral hygiene or their lifestyle choices—vaping, smoking, sugary drinks, acidic diet colas, stress—these
are all contributing to trends of an increase in tooth decay and gum disease among teens and young adults.”
Delegate some of the messaging to your family dentist and hygienist when your teen goes in for checkups and regular cleanings.
“The hygienist will help educate them to ensure their hygiene techniques are most effective. They can also discuss lifestyle issues that affect plaque buildup,” Maragos says.
Tip # 7 – Support Your Young Adults
After your kids leave the nest, encourage continued good dental habits through care packages with toothbrushes, toothpaste and floss bearing the ADA Seal of Acceptance. And coordinate with them to schedule dental checkups and cleanings when they’re home on break. Or help them find a dentist near campus or their new job to ensure they keep up with their regular maintenance visits.
Tip #8 – Consider the Consequences
If you or your children avoid flossing, you’ll eventually experience decay and cavities between the teeth. This can be painful, expensive, aesthetically compromising, and potentially worse.
Ultimately, “We can repair and replace teeth but prevention is better,” Maragos says.
