Dr. Chip Tartaroff Answers Your Flossing Questions
Do you have a pressing question about floss and it’s proper uses?
Send your question to Dr.T@flossing.org
Ask, Dr. Tartaroff
Your Flossing Questions, Answered...
Page 1 of 2
Page 2 Topics:


What's Up With the Tooth Fairy?
One Type of Floss is Enough!
How many people floss regularly?
Too Much Flossing?
Youngest Age to Start Flossing?
Floss or Brush First?
Ooo - The Smell!
Flossing In Public?
Where's My Floss?
How To Floss?
What is "Peace of Mouth?"
Flossing Can Be Good For Your Health!
Dr Chip Tartaroff, DDF

A Wisdom Tooth Dilemma!

Dear Dr. T,

I was just going through the queries and your answers and I thought I had to ask this.

I am usually very careful about my teeth. I have got beautiful choppers and obviously I would like to have them for as long as I can. I used to brush twice a day, scrap my tongue twice and also used a mouthwash. I have never had cavities or any tooth related problems and I am 28.

The problem began when I started having those wisdom teeth. They don't pain much but they seem to be taking their sweet time in coming out completely. Every month or two they seemed to try to push themselves and when it happened my gums turned all sore and I would bleed while brushing. I also do oil pulling occasionally with coconut oil and few drops of clove oil. But the bleeding scared the hell out of me.

It's then that I started flossing. Even now I have not mastered the art of flossing and I find it very difficult to reach the last  eight. I usually do a warm saline water mouth rinse after supper and then floss followed by brushing, tongue scrapping and Listerine. The bleeding has stopped but I am still confused with the order of my routine.

Please suggest the best way. I really love my teeth.

Regards,

Smita


Dear Smita,

From one tooth lover to another - it was great to hear from you!

Thanks for writing and sharing what you do for your personal dental care! Unlike you, there are people who have good teeth and no cavities but wind up losing teeth to gum disease because they don't do regular dental care.

In order to speak to your question we have to agree that there will never be any one way to do things as complex as dental care, so let's focus on what's seems to be your current significant dental issue - your emerging wisdom teeth.

Since you mentioned that you're 28, the wisdom teeth are a bit late, but not something so unusual by itself. The age range for their eruption runs between 16 & 30. Some wisdom teeth never emerge.

The gum irritation or inflammation you describe is not uncommon as wisdom teeth erupt and is an important factor affecting how you should currently care for your mouth.

Wisdom teeth are not my specialty, so I shared your question with Dr Jay W. Friedman, DDS, MPH who's had a long career in clinical dentistry and written a very important article on the unnecessary removal of wisdom teeth.

In his reply, Dr. Friedman commented that if you have persistent or periodic pain around an emerging wisdom tooth, with or without bleeding, it might be justifiably removed. Of course this is something you have to discuss with your dentist who will have x-rays of the teeth to help make a decision. Dr. Friedman also noted that if the teeth can erupt or have erupted, sometimes all that is necessary is to remove the gum tissue around the tooth rather than the tooth itself (called a operculectomy). Be sure to ask your dentist about this option!

Best of luck with your “growing pains.” I'm sure you'll return to “Peace of Mouth” after a little time.

One other matter for your consideration is something Dr Friedman points out in his excellent book, Complete Guide to Dental Health, - too frequent use of Listerine or other antibiotics can upset the natural balance of organisms in the mouth. When the balance gets upset, a normal resident can bloom, causing over growths that produce mouth problems. Please keep this in mind when your possibly infected wisdom teeth aren't an issue. Dr Friedman says the warm salt water that you're already using is probably the best and cheapest mouthwash.

Let's close by saying something about floss - I'm sure you'll get good at flossing once your new teeth have settled in and given you a chance to practice!

Floss on!

Dr. T

Dr. Jay W. Freidman, DDS, MPH
“Simply brilliant”

Note from Dr T:

We received the following email from a very kind reader who shared her agony from having food stuck in her teeth as well as the relief she got from finding a way to deal with her problem.

It's rewarding to hear that some of the info we're trying to pass along about flossing has been useful.

Many thanks for your letter, Relieved Reader!


Dear Dr. T,

I don't normally find myself writing to online people that I don't know; but I have to send an email of thanks!

I have been battling a flossing issue for YEARS. Yes years!  I have teeth that are tight and some that are wide. I have two food traps that drive me crazy. Food gets stuck in there and it actually hurts. 

One of your answers said to try tying a knot in my floss. That is unbelievable. This has worked so well. It has brought so much relief to my poor teeth.  

I had flossed so hard at one point that within a week I had pulled off 2 crowns. I love to floss but didn't know how to floss for different teeth.

Thank you so much for your information. My teeth feel great!!!

Sincerely yours,
Relieved Reader


Too Much Force?

Hello Dr. T,

I love floss!!
I make my friends floss at sleepovers and they hate me for it but I know that flossing is important!!!
I wanted to know if there was national floss day and there is I'm soo excited about it.
I oddly enough enjoy flossing and feeling I've cleaned my teeth to their finest.
What does the national flossing council do?
What does it take to attend a meeting or be in the council??
I love floss !! Please reply so I know it's real!

Avid Floss Fan


Hey AFF,

Great to hear from you and all about your love of floss!

Yes there is a National Flossing Council and National Flossing Day is always the day after Thanksgiving - so start getting ready, barely 8 months left to prepare.

Flossing is important, but treating your friends nicely is very important too.

You know the Hunger Games movie? See what forcing people to do things can lead to?

Why not try some other tactics, rather than force?

When you're having a sleepover, just happen to have a few different types of floss available for your friends - different flavors and varieties like Glide (Teflon flosses) - people with tight teeth need to use none shredable flosses that slip easily between teeth.

Set a good example by flossing and encourage your friends to join you.

Doing more than that and you may risk having people floss with you but be so aggravated about being forced to floss, they stop flossing to spite you and themselves. Not good. You may reduce the number of flossers!

Keep up your enthusiastic love of floss and work on spreading the word - but remember that too much forcing can work against what you'd like to see happen.

To find out more about what we do, check out the stuff on the flossing.org website and read some of the posts on the NFC Blog.

I think you'll see how we're trying to make flossing cool.

We don't have meetings, but if you get a flossing idea you'd like to share, email again.

Floss on!
Dr. T.


Do You Use A Floss Holder?


Dear Dr. T.,
You  make no mention of any of the numerous floss-holders that are available. I never used to floss until I almost lost 8 of my back teeth due to the roots having decayed to the degree that I had to have surgery where the gums had to be cut and lifted off the teeth so that the decayed area of the roots could be 'scratched off'.

This was an agonizing ordeal that had to be done over a month and took four separate surgeries, one for each quarter of the mouth.

It was such a shock for me that I spent hours on the internet searching for a simplified, if not easier, way to floss. Flossing was just too difficult to do. I came across 2 different items for sale and have been flossing daily ever since. (The 2 gadgets I bought are good).

Yet you never mention any of the items sold for making flossing easy, or at least easier. Why? Is it because you don't believe these gadgets work? Or is it because you will be accused of 'pushing' a product in the form of indirect advertising?

Sincerely,
Ivan P.


Dear Ivan,

Thanks for your note!

I'll start my reply from the end of what you wrote – I haven't talked about floss holders because I don't use them and no one, before you, has asked about them. It's also true that I'm not interested in “pushing” particular products.

As I say in another spot, I think flossing will have helpful effects whether it's done with string from a sewing box or a fine designer “tea tree” floss. I guess I should add “or with a floss holder.”

Cleaning between your teeth where food and crud can sit – out of reach of a toothbrush – is what flossing is all about. What kind of floss and how you get the floss there aren't too important.

But some people, like you, find the addition of a floss holder makes flossing much easier and convenient, and it actually gets them to floss. Which is why I'm very happy you wrote to let others know your experience!

In my back teeth, I have some old amalgam fillings that catch floss if I try to pull it up and out, so I like having a free end on my floss to slide it out from between my teeth. That limits my use of those small y shaped floss holders and keeps me a “free rangin' flosser” with no holder at all.

I'm very happy to hear you have done so well with the floss holders you've found (I checked back with Ivan and found he particularly likes “floss rings”*).

Other readers are encouraged to send word of their experience with other floss holders (good or bad) to share. This isn't a site for “pushing products,” but it is a place you can share your honest experience with flossing aids/gadgets.

Floss on, Ivan!

Sincerely,
Dr. T.

*Floss Rings were developed by Sean Dix in the 1990s. Apparently, Mr. Dix is not one who believes “Any press is good press.” After a bad report on floss rings on CNN and a long period of frustration about getting his side of the product story told, Sean Dix feigned a threat on the life of Ted Turner to get attention to his complaints. The tactic got him 2 years in jail. For a telling of the full story: http://rense.com/general82/floss.htm

I Don't Floss

Dr T,

Okay, so I don't floss.
At all.
Now don't be disgusted just yet!
The reason I don't floss is because I feel like I don't need to.
There are spaces/gaps between ALL my teeth - I'm not kidding.
I don't see how food could get stuck there, I would feel it as the spaces are quite large.
Am I right in my reasoning?

Moon

ps. I wish I could afford braces :(

pps. what's the verdict on adult braces? I'm 23.


Hi Moon,

So you don't floss. Based on how you describe your teeth, you may not need to.

Even though you're not a flosser, I'm glad you decided to write and ask about it.

You probably hear about flossing a lot, and it's made you "flossing curious."

There is a simple way you can figure out if not flossing "at all" is right for you.

Honestly, as I've mentioned elsewhere, for me, the food stuck between my teeth is probably the prime reason I got to be such a floss sympathizer.

Not you, however.

But there are other reasons to floss, and for you, I'd suggest a simple test.

Take a piece of floss and gently run it along the edges of your teeth - – especially your back teeth.

Check for two things -

First, does the floss smell?

If you answer yes, it's a sign your brushing isn't cleaning enough around the base of some teeth. The smell is from the bacteria and food debris in your mouth that can cause bad breath and cavities.

The second thing is whether there is blood on the floss.

Since you're not a flosser, and regular flossing does toughen up your gums, even if you're gentle, a little bleeding might happen. But regularly seeing blood on floss or your tooth brush is a sign of sickly gums. Sucking on some vitamin C might be helpful (see "Floss Your Roots," below), but more brushing and flossing will certainly help. Some people have great teeth with few if any cavities but get over confident about their mouth and develop big problems with gum disease.

Gum problems are what I'd suggest you watch out for and use floss to check your gum health from time to time.

Quick note regarding braces - – they work, but they take about 2 years and cost $.

Wiki has a good piece on them: http://en.wikipedia.org/wiki/Dental_braces

I've heard about people in their 50s using the new clear braces. By the time you're 25, your braces could be off. If you're lucky, the braces will also be paid off by then.

Thanks again for writing!

Cheers,

Dr. T

A Postcard of Questions from Wisconsin!
Dear Sue Williams,

Thanks for your postcard and all of your questions!
As you know I sent you a postcard with the website address so you can read this and get a few answers.

Here we go!

In your card you say you like waxed floss and you want to know if there are some brands that are better than others.

Well, Sue, the best floss is the one you like to use and like enough to floss regularly.

It's not something special about the floss that cleans your teeth. It's about you flossing regularly.

The goal of flossing is to clean spaces between your teeth that other cleaning techniques can't get to.

String can bend around the sides of teeth and even get down between the edge of your gums for many teeth. Much like mice that can hide in hard to reach spots around a house, food, bugs and tartar hide in our mouths need to be dislodged or at least loosened with floss so that other activities like brushing and chewing can keep them from growing into problems like cavities and diseased gums.

Next you asked about who makes floss.

Here's a link that claims to include all brands of floss.
The biggest companies making dental floss include Procter & Gamble (Crest/Glide & Oral B) and Johnson & Johnson (Reach). But a trip to any drugstore nowadays will let you find a lot of smaller brands of dental floss like Tom's Of Maine (This isn't a plug. I happen to notice it's not on the link claiming to show all brands of floss).
It warms the heart to see so many new flosses!

Thanks again for your card! Floss on, Sue!

Dr. T.

Floss Your Roots?

Dr. T,

I am 45 and recently started daily flossing. When i floss my front lower teath, I can feel an edge, and assume and I am coming to the end of my enamal , and hitting the root. It does not hurt, but seems wierd

1)do i floss below that lip (so i would be flossing the root?)
2)do i need to have that gum replaced?

Tom



Dear Tom,

Thanks for writing!

First of all, I am not a professional dentist and I do not play one on TV.

However, that won’t stop me from offering some common sense comments
in reply to your question, but nothing I say should stop you from discussing your concerns with a dentist.

From what I understand, recession of gum tissue is a fairly common event and it roughly correlates with age. Complicating the relatively natural amount of recession, gum disease can hasten the process and cause it to endanger the retention of teeth. In your case it sounds
like you have some gum recession on your front lower teeth. One of the primary issues that draws a person’s attention to their gum’s recession is sensitivity of the roots when they’re exposed. This
doesn’t seem to be a problem for you.
Should you floss those areas?
I’d say yes, based on the scientific principal: If it hurts, don’t do it – and you mentioned flossing didn’t hurt.

As you may know, the normally exposed parts of teeth are covered with enamel. The surface of roots is referred to as “cementum.” Decay can occur in enamel and cementum, so it’s important to keep these tooth surfaces clean, which means using floss.

The second part of your question – Should you have a gum transplant to cover the exposed roots? – Well, a dentist will have to discuss that.
But here are some considerations that might pay to keep in mind:
What is the likelihood that the new gum tissue will survive where your original gum tissue has retreated?
Some gum recession is attributed to overbrushing. Overbrushing is something you can change, but it might be best to wait on a painful transplant procedure to see if changed brushing permits gum regrowth.

Also keep in mind that gums love vitamin C. One of the first signs of vitamin C deficiency (aka “scurvy”) is loose teeth. Gum tissue grows rapidly and vitamin C (ascorbic acid) is fundamental for cell growth
and repair. This is a primary reason a shortage of vitamin C shows itself with bleeding gums and loose teeth. You can’t conclude that all gum problems and loose teeth are caused by a shortage of vitamin C, but when these problems occur, a brief period of vitamin C supplements seems reasonable before anything more costly and painful is tried.

By the way, the worst side effect of too much vitamin C is flatulence (as in “toot-toot”). Sucking on a small amount of vitamin C (30-60 mg) 1 or 2x/day should get your gums all they can use and not cause any
gastric distress. Some cough drops contain vitamin C and make a tasty way of getting a supplement.

Good luck with your gums, Tom!

Floss on!

Dr. T.
Flossing Frequency?

Dr. T.,

After many years of very average dental hygiene and barely any flossing, something finally "clicked" for me after getting 6 fillings recently. I have finally changed my ways and become fairly fanatical about tooth cleanliness. I keep a toothbrush and floss in my desk drawer at work, and I find that after every meal, I feel an urgent need to floss and brush, in order to remove all debris and have a clean mouth again. it's kind of like the instinct to wash your hands after digging in the dirt.

I have now got a routine in which I brush and floss at 10am (to clear breakfast debris), then again at 2pm (to clear lunch debris) and after dinner (8pm). My question is do you feel this is too much flossing? I have gaps between my teeth that are just large enough to keep debris between them, so I know you are supposed to floss once a day. But I have this huge urge to get that debris out soon after eating. What do you suggest?

Best wishes

3x a day flosser in NC


Dear 3XADFINC,

Thanks for your question!

I have to start off by saying that I am also a 3x a day flosser, so you have an idea where this is going.

Here’s the the basic question that we need to consider: Will flossing 3x a day harm your teeth and what problems could it cause?

All those readers with tight teeth could probably go read elsewhere at this point, since they have no idea how annoying it is to have a substantial part of a meal stuck between your teeth after eating. Of course, as you’ve described, they also don’t understand how satisfying it is to get that jammed food out from between teeth with floss. As I’ve said before, tight teeth don’t catch much food and they don’t have much room for floss. Those “tight” teeth still need a periodic cleaning with a non-shredding floss, since bacteria and plaque buildup can happen even in the small spaces between the tightest teeth.

Let’s keep this brief – too much flossing really isn’t a problem, but “improper” flossing can erode enamel.
What is “improper” flossing?
Well, floss can serve two useful roles:

1. Removing large pieces of food stuck between teeth, and
2. Cleaning food residues from spaces between teeth where brushing won’t reach.

“Improper” flossing involves pointless rubbing floss against the enamel. This is why you’ll hear warnings about “don’t saw back and forth” with floss.

How do we know that “sawing” with floss will hurt enamel? Well, you can check these links (1,2) for two examples (and there are others) of prisoners using floss to saw through metal bars to escape. Let’s face it, if sawing with floss can cut metal, the enamel on your teeth can get “groovy” with too much sawing. The grooves you can cause with floss might be a cosmetic problem, but more important is the damage they do to surface enamel and the spaces they make for decay-producing bacteria.

You might also be interested to learn that there are a few anthropology studies that report finding grooves on the teeth of ancient skeletons that suggest damage from repeated rubbing with fibers (ie. floss)(3,4). One report is based on skeletons from Pakistan and the other from the prehistoric natives in the western US – so this isn’t a rare or localized misuse of floss.

What to do? Clean the big pellets of food from between your teeth when they bother you. A short forward or back motion may be needed to dislodge debris – but no sawing! To clean the spaces between teeth, pull the floss up and down along the teeth. This up and down cleaning between all your teeth isn’t the type of flossing you need to do very often. Once a day for this type of thorough flossing will be fine to keep your teeth really clean.

Thanks again for your question!

Floss on!

Chip T.


Citations:

Jailbreaks

1. Inmate used dental floss to escape cell
Associated Press, Tuesday, 21 March 2000

2. Inmate uses dental floss, toothpaste to escape prison
Associated Press, 04/25/02

Ancient floss damage

3. Activity-induced patterns of dental abrasion in prehistoric Pakistan: Evidence from Mehrgarh and Harappa
John R. Lukacs, Robert F. Pastor
American Journal of Physical Anthropology
Volume 76 , Issue 3 , Pages 377 - 398, 1988.

4. Task activity and anterior tooth grooving in prehistoric California Indians
Peter D. Schulz
American Journal of Physical Anthropology
Volume 46 Issue 1, Pages 87 – 91, 1977.
Published Online: 29 Apr 2005


How Deep To Floss?

Hi Dr. T,

I was recently told that when flossing there is no limit to how deep you should try and go. I used to make the "C" shape go blow the gum-line as far as felt natural (so about 2 or 3mm beyond the gum's normal level) and "scoop up" 3 or 4 times (no sawing). Now I'm trying to go further but beyond a point it feels very sensitive, like I can feel the nerve almost. So I'm wondering if I'm going too far and what you'd advise.

Thanks,

Graham


Dear Graham,

Thanks for your question!
There's a saying from an old advertisement that "You only need to floss the teeth you want to keep."
But sometimes enthusiastic flossers need to be reminded that certain styles of flossing can damage your gums and that is not a way to help keep your teeth healthy.
In your case, the suggestion that "there is no limit to how deep you should try and go" with floss sounds troublesome to me.
Keep in mind that flossing is intended to clear out debris and plaque. Using floss to delve to new depths under your gums just isn't necessary - you can leave that for an occasional thorough cleaning. Exploring such depths on a regular basis is likely to do more harm than good.
You know the nerve you think you're feeling - you're probably right.
If you read the letter below by Jay Friedman, "Too Much Flossing?", you'll learn about someone who was tearing at his gums with knots in his floss. That doesn't mean putting a knot in your floss, as also suggested below by Mixed Space Guy ("One Type of Floss Is Enough"), can't sometimes be a handy way to floss certain teeth more thoroughly.
Floss is a tool, and, like any tool, it can play a healthful role in caring for your teeth. Of course, any tool used badly can do more harm than good.
Based on your comments, you seem to use good basic flossing techniques. Keep up the good work - just hold back a bit on the depth of your flossing.
Floss on!

Dr. T.

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