A review of trials concluded that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone.[1] 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."
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 Corporationreceived 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.
Dentists and dental hygienists urge the daily oral hygiene regimen of toothbrushing and flossing. Nearly all Americans brush their teeth. However, studies have found that only 10% to 40% of Americans report flossing on a daily basis.[3]
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 gumlineto remove particles of food stuck between teeth and dento-bacterial plaque that adhere to such dental surfaces. Ideally using a C-shape, the floss is curved around a tooth and placed under the gumline, and then moved away from the gumline, the floss scrapes the side of each tooth, and can also clean the front or back of the tooth. Gently moving the floss from below the gumline to away from the gumline removes dento-bacterial plaque attached to teeth surfaces above and below the gumline. A clean section of floss can be used to clean each tooth to avoid transmitting plaque bacteria from one tooth to another.
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.
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.
Occasional flossing and/or improper flossing can typically lead to bleeding gums. The main cause of the bleeding is inflammation of the gingival tissue due to gingivitis.
The American Dental Association advises to floss thoroughly once or more per day. While they do not make a recommendation regarding the order of brushing and flossing, flossing prior to brushing allows for fluoride from the toothpaste to reach between the teeth.[4] Overly vigorous or incorrect flossing can result in gum tissue damage. For proper flossing, the Association advises to curve the floss against the side of the tooth in a 'C' shape (making sure the floss does notsnap into the gap[5]), and then to wipe the tooth from under the gumline (very gently) to the tip two or three times, repeated on adjacent and subsequent teeth.
Flossing in combination with toothbrushing can prevent gum disease,[6][dead link] and halitosis.[7][dead link]
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.
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]
In 1888, B.T. Mason wrapped a fibrous material around a toothpick and dubbed it the 'combination tooth pick.' In 1916, J.P. De L'eau invented a dental floss holder between two vertical poles.[9] In 1935, F.H. Doner invented what today's consumer knows as the 'y'-shaped angled dental appliance. In 1963, James B. Kirby invented a tooth-cleaning device that resembles an archaic version of today's F-shaped floss pick.
In 1972, an inventor named Richard L. Wells found a way to attach floss to a single pick end. In the same year, another inventor named Harry Selig Katz came up with a method of making a disposable dental floss tooth pick. In the early 1990s floss picks became mass marketed in various versions. Floss can help prevent gum disease when used regularly.