Dental floss

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Dental floss is an interdental cleaning aid (i.e. cleaning between teeth). It is a cord of thin filaments used to remove food and dental plaque from teeth. The floss is gently inserted between the teeth and wiped along the teeth sides, especially close to the gums or underneath them. Dental floss may be made of either plastic (nylon, PTFE or polyethylene) or silk, and can be flavored or unflavored, and waxed or unwaxed. An alternative tool to achieve the same effect is the interdental brush, which is better suited where the gap between 2 teeth is wider.

Toothbrushes do not clean between teeth or below the gumline. Flossing in addition to toothbrushing can reduce gingivitis and halitosis compared to toothbrushing alone. There is weak evidence that flossing plus toothbrushing may help to reduce plaque buildup relative to toothbrushing alone.[1]

Dental hygienist flossing a patient's teeth during a periodic tooth cleaning.

History[edit]

Dental floss

Levi Spear Parmly, a dentist from New Orleans, is credited with inventing the first form of dental floss. In 1815, he recommended that people should clean their teeth with silk floss.[2]

Dental floss was still unavailable to the consumer until the Codman and Shurtleft company started producing human-usable unwaxed silk floss in 1882. In 1898, the Johnson & Johnson Corporation received the first patent for dental floss. Other early brands included Red Cross, Salter Sill Co. and Brunswick.

A character is depicted using dental floss in James Joyce's famous novel Ulysses (serialised 1918-1920) and is an early mention of the practice in literary fiction.

The adoption of floss was poor before World War II. It was around this time, however, that Dr. Charles C. Bass developed nylon floss. Nylon floss was found to be better than silk because of its greater abrasion resistance and elasticity. In response to environmental concerns, dental floss made from biodegradable materials is now available.

Dental professionals encourage daily use of floss in addition to twice daily toothbrushing with fluoride toothpaste, however, flossing tends not to be a common an oral hygiene practise compared to brushing. In the United States for example only 10 - 40% floss on a daily basis whereas almost everyone brushes.[3]

Use[edit]

Flossing should be carried out once per day. Flossing prior to brushing allows for fluoride from the toothpaste to reach between the teeth.[4]

Dental floss is commonly supplied in plastic dispensers that contain 10 to 100 meters of floss. After pulling out the desired amount, the floss is pulled against a small protected blade in the dispenser to sever it.

Dental floss is held between the fingers or strung on a fork-like instrument. The floss is guided between each tooth and under the gumline to remove particles of food stuck between teeth and dental plaque that adhere to such dental surfaces. The floss should be gently curved against the side of the tooth in a 'C' shape, and then wiped under the gumline (very gently) to the tip two or three times, repeated on adjacent and subsequent teeth.

There are many different kinds of dental floss commonly available. The most important variable is thickness. If the floss is too thick for the space between a pair of teeth then it will be difficult or impossible to get the floss down between the teeth. On the other hand, if the floss is too thin, it may be too weak and break. Different floss will suit different mouths, and even different parts of one mouth. This is because some teeth have a smaller gap between them than others. It's possible that thicker floss does a better job of scraping bacterial plaque off teeth, given that there is space enough between the teeth to use it. When a piece of hard food is tightly wedged between the teeth, one may need to switch to thinner floss, because thick floss cannot get past the food. It is possible to split some kinds of dental floss lengthwise generating a pair of thinner pieces that are much weaker but sometimes usable. This is possible because some kinds of dental floss are made of many very thin strands that are not woven together but rather run more or less in parallel. This can also be useful if the dental floss you have is too thick for you, for any other reason, and you do not have access to any other, for example when travelling in a foreign country. Many people with little space between their teeth prefer waxed dental floss as it glides more easily. Some waxed types of dental floss also contain antibacterial agents and/or sodium fluoride. The ability of different types of dental floss to remove dental plaque from between the teeth does not vary significantly,[5]:37 i.e. the very cheapest type of floss has a similar impact on oral hygiene as the most expensive.

F-shaped and Y-shaped dental floss wands
Ergonomic flosser with swiveling, disposable heads

Specialized plastic wands, or floss picks, have been produced to hold the floss. These may be attached to or separate from a floss dispenser. While wands do not pinch fingers like regular floss can, using a wand may be awkward and can also make it difficult to floss at all the angles possible with regular floss. These types of flossers also run the risk of missing the area under the gum line that needs to be flossed. On the other hand, the enhanced reach of a wand can make flossing the back teeth easier.

Ergonomic flossers with improved handle for better grip and swiveling floss heads allow easy access to any pair of teeth in the mouth, to the front teeth as well as to the rear teeth. Their floss heads also feature a lateral flexibility that enables improved control for the dental floss to hug the sides of the teeth and clean under the gum line without the danger of hurting the gums.

Individuals who have not flossed before may be put off from flossing when they notice bleeding gums after flossing. This bleeding is a sign that there is gingivitis (inflammation of the gums), meaning that flossing needs to be carried out regularly, not avoided.

Poor flossing technique, using a forceful sawing motion, can damage the tissues and can also cause bleeding. Flossing immediately after the placement of amalgam fillings can result in an amalgam tattoo.

Benefits[edit]

Flossing in combination with toothbrushing can help prevent gum disease,[6][dead link] and halitosis.[7][dead link] A 2012 review of trials concluded that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone. In this review, researchers found "some evidence from twelve studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone" but only discovered "weak, very unreliable evidence from 10 studies that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 and 3 months."[1]

Floss threader[edit]

A floss threader is loop of fiber (similar to fishing line) used to thread floss into small places around teeth. Threaders are sometimes required to floss with dental braces, fix retainers, and bridge.

Floss pick[edit]

A floss pick is a disposable oral hygiene device generally made of plastic and dental floss. The instrument is composed of two prongs extending from a thin plastic body of high-impact polystyrene material. A single piece of floss runs between the two prongs. The body of the floss pick generally tapers at its end in the shape of a toothpick.

There are two types of angled floss picks in the oral care industry, the 'Y'-shaped angle and the 'F'-shaped angle floss pick. At the base of the arch where the 'y' begins to branch there is a handle for gripping and maneuvering before it tapers off into a pick.

Floss picks are manufactured in a variety of shapes, colors and sizes for adults and children. The floss can be coated in fluoride, flavor or wax.[8]

History of floss pick[edit]

In 1888, B.T. Mason wrapped a fibrous material around a toothpick and dubbed it the 'combination tooth pick.'[9] In 1916, J.P. De L'eau invented a dental floss holder between two vertical poles.[10] In 1935, F.H. Doner invented what today's consumer knows as the 'y'-shaped angled dental appliance.[11] In 1963, James B. Kirby invented a tooth-cleaning device that resembles an archaic version of today's F-shaped floss pick.[12]

In 1972, an inventor named Richard L. Wells found a way to attach floss to a single pick end.[13] In the same year, another inventor named Harry Selig Katz came up with a method of making a disposable dental floss tooth pick.[14] In the early 1990s floss picks became mass marketed in various versions.

See also[edit]

References[edit]

  1. ^ a b Sambunjak, D.; Nickerson, J. W.; Poklepovic, T.; Johnson, T. M.; Imai, P.; Tugwell, P.; Worthington, H. V. (2011). "Flossing for the management of periodontal diseases and dental caries in adults". In Johnson, Trevor M. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD008829.pub2.  edit
  2. ^ Sanoudos M, Christen AG. (1999). Levi Spear Parmly: The Apostle of Dental Hygiene. Journal of the History of Dentistry. 47(1): 3-6.
  3. ^ K. Bauroth, et al. Journal of the American Dental Association, Vol 134, No 3, 359-365. "The efficacy of an essential oil antiseptic mouthrinse vs. dental floss in controlling interproximal gingivitis". Accessed 15 November 2009.
  4. ^ American Dental Association, "Floss and Other Interdental Cleaners". Accessed 12 April 2010.
  5. ^ Heasman P (editor) (2008). Restorative dentistry, paediatric dentistry and orthodontics (2nd ed.). Edinburgh: Churchill Livingstone. ISBN 9780443068959. 
  6. ^ American Dental Association, "What does floss do?". Accessed 28 November 2009.
  7. ^ American Dental Association, "Bad Breath (Halitosis)". Accessed 28 November 2009.
  8. ^ "Floss and Other Interdental Cleaners". American Dental Association. 
  9. ^ "Patent US407362 - Combination tooth-pick - Google Patents". Google.com. Retrieved 2014-04-13. 
  10. ^ "Dental Floss Holder". U.S. Patent. 
  11. ^ "Patent US2076449 - Dental instrument - Google Patents". Google.com. Retrieved 2014-04-13. 
  12. ^ "Patent US3106216 - Tooth cleaning device - Google Patents". Google.com. Retrieved 2014-04-13. 
  13. ^ "Patent US3775849 - Dental handpiece attachment - Google Patents". Google.com. Retrieved 2014-04-13. 
  14. ^ "Patent US3926201 - Method of making a disposable dental floss tooth pick - Google Patents". Google.com. Retrieved 2014-04-13. 

External links[edit]