Brushing our teeth twice a day is a habit that most of us take for granted. It’s such an ingrained part of our morning and evening routines that we don’t even think about it anymore.

Regular brushing is essential to keep our teeth clean and our gums healthy. But even the most thorough go-over with the toothbrush can’t get to every nook and cranny. Those tight gaps between our teeth are particularly tricky, and it is easy for plaque to build up here.

The solution to this is a simple one. Floss. The American Dental Association recommends cleaning between our teeth once a day, either with floss or with another form of interdental cleaner. This isn’t ground-breaking advice, though. We’ve probably been hearing it from our dentists since we were kids. However, knowing we should do something and actually doing it aren’t necessarily the same thing.

According to survey data published in 2018 in The Journal of Periodontology, only around 31% of Americans over 30 years old floss daily. In fact, slightly more people admitted that they don’t even floss as often as once a week.  In some ways, this is no surprise. We’ve been told that flossing is good for our teeth, but it is time-consuming, fiddly, and can be painful. When our mornings are already packed full, it can be tempting to let flossing slide to save time.

However, regular flossing is an essential part of keeping our teeth and gums clean and healthy. And not keeping up with our oral hygiene can have consequences for our overall health too. Today, we’re diving deeper into the benefits of flossing and why it should be a daily part of everyone’s routine.

The Benefits of Flossing

Just as brushing on a regular schedule keeps our teeth, gums, and tongue healthy, flossing plays a vital role in our dental hygiene. Tiny pieces of food can easily become trapped between our teeth and are difficult to dislodge through brushing alone. While we’ll hopefully see and remove any larger pieces (avoiding the classic spinach-in-the-teeth scenario), any food we miss combines with saliva and creates the conditions for plaque to form.

What is plaque? It’s that sticky film that builds up on your teeth in between brushes -- and it’s made of bacteria. When we eat or drink, especially foods or drinks that contain sugar, these bacteria release acid which attacks our teeth. This process can lead to cavities and tooth decay.

One of the main reasons we’re told to brush our teeth twice a day is to remove plaque before it can damage our teeth. This also stops the plaque from hardening into tartar. The American Dental Association warns that tartar makes it harder to keep our teeth clean -- and can lead to gum disease.

Early gum disease is called gingivitis, and it causes swollen, red gums. It can also result in some bleeding when cleaning your teeth. And it can make your breath smell bad too. If gingivitis is left untreated, it can get worse, turning into periodontitis. This is an inflammatory form of gum disease that can cause issues beyond just your dental health (more on this in a moment).

As you can see, regular cleaning is vital if we want to avoid plaque build-up, cavities, and gum disease. Since brushing on its own won’t remove plaque from between our teeth, flossing is a daily necessity to avoid any issues with our teeth and mouths.

Some of the benefits of flossing include:

1. Removing plaque
2. Reducing the risk of cavities
3. Preventing the build-up of tartar
4. Decreasing the likelihood of developing gum disease

And let’s not forget benefit #5 -- preventing bad breath. Because the bacteria that accumulate in our mouths aren’t only bad news for our teeth. They also cause smelly breath. The food particles that get trapped between our teeth attract bacteria, as we’ve seen. Those bacteria produce waste products that smell foul and result in bad breath.

There are other sources of bad breath, including smoking, strong-smelling foods, dry mouth, and certain medications. But the Oral Health Foundation says it is most often caused by bacteria or small pieces of food that have been missed when we brush.

By flossing regularly, we remove more of the bacteria and scraps of food that create the odor, preventing bad breath.

Flossing and Heart Health

It stands to reason that flossing regularly helps keep our mouths and teeth healthy. But it turns out that there is an even more pressing reason to care about our dental hygiene.

According to data published by the National Center for Health Statistics, heart disease remains the leading cause of death in America. And there’s a growing body of research that suggests a link between our oral health and the health of our hearts and cardiovascular systems.

Studies have found a correlation between poor oral hygiene and the risk of having a heart attack. For example, a large-scale Australian study published in 2016 looked at data from 172 630 people. The researchers found that those who reported poor oral hygiene were at higher risk of heart disease.

Similarly, a 2018 study looking at adults in America found that those with gum disease were more likely to have issues with blood pressure and were less likely to respond well to treatment.

So far, the jury is out as to the exact relationship between heart disease and oral health. Because gum disease is relatively common (and so, sadly, is heart disease), it could simply be a coincidence instead of a causal link.

This was the conclusion of a 2018 study that aimed to analyze the situation further. Like other studies, this one found a correlation between tooth loss and heart disease. However, when the researchers split results into groups, depending on whether the person was a smoker or a non-smoker, the correlation vanished -- but only for men. In women, the association between dental health and heart disease remained.

Research like this shows there is still some way to go in establishing the exact nature of the connection between oral health and heart problems. However, many in the medical community believe that there is a link. The American Heart Association advises people to look after their oral hygiene to protect their overall health and wellbeing.  

The link may be down to inflammation, the mechanism that underlies many chronic diseases, including heart disease, strokes, diabetes, Alzheimer’s, and rheumatoid arthritis.

Advanced gum disease is an inflammatory condition. This may add to the overall levels of inflammation in the body, putting us at higher risk of other diseases associated with inflammation.

There’s some evidence to support this theory. Poor oral hygiene has also been linked to other chronic diseases, including rheumatoid arthritis, diabetes, and dementia.

That’s a pretty scary list.

While further research is needed, if keeping our mouths clean can help us to reduce our risk of these diseases, it seems like a no-brainer. Taking a few extra minutes once a day to floss as well as brush our teeth is a small sacrifice to make for our long-term health.

So, benefit #7 is a pretty major one – flossing may reduce our risk of heart issues and other chronic diseases.

When to Floss

The good news is that you only need to floss once a day, according to the American Dental Association. And it doesn’t matter too much whether you floss in the morning, the evening, or even in the middle of the day.  You will want to do it at the same time as you brush your teeth, however.

Since flossing adds a few extra minutes to our bathroom routine, those rushing to get children out of the house in the morning might find it easiest to do it at night. On the other hand, if you are exhausted in the evenings and want to avoid yet another step in your bedtime routine, morning might be a better time for you.

Like any habit, finding a time of day that works for you and making a commitment to flossing consistently will help you to make this a regular part of your daily routine.

How to Floss

Break off a long piece of floss – around 20 inches or so. Wind most of it around your fingers, leaving a 1–2-inch section for your first tooth.

Keep the floss taut, holding it between your index fingers and thumbs. Use a gentle rubbing motion to move the floss in between two teeth, then move it in a C shape to get it up between your teeth and your gums. Don’t dig it into your gum, which can cause pain.

Repeat this for each tooth, using a clean section of floss for each gap. It might feel strange or uncomfortable at first. Like anything, flossing gets easier with practice.

Choosing a Floss

One of the issues with most conventional dental floss is that it is made of nylon, an artificial fiber derived from petrochemicals. In other words, nylon is a form of plastic. For those of us who try to keep our homes environmentally friendly and free from toxic chemicals, plastics like nylon are a real problem. In addition to the nylon, many of the conventional floss packaging is a plastic container.

If the toxic chemicals within plastic isn't enough to steer you clear from them, they also impact our environment and oceans.

Not only does it not break down in landfills, but the process used to make it requires loads of energy. And the manufacturing process also emits nitrous oxide, a greenhouse gas that is even more damaging than carbon dioxide.

At Wellnesse, we’re committed to keeping our families healthy and well. But not at the expense of the planet. So, we knew we needed to come up with an alternative. An eco-friendly floss (and packaging!) that still leaves our mouths sparkling clean.

And we’re proud to announce we’ve done it. Our new dental floss is made from just three ingredients: silk, peppermint oil, and candelilla wax. This makes it a safe, non-toxic alternative to the environmentally damaging materials used to make conventional floss. So, we can all look after our teeth with a clear conscience.

You can find our new floss along with other oral hygiene essentials to help you care for your whole family’s teeth.

Resources

The American Dental Association, Federal Government, ADA Emphasize Importance of Flossing and Interdental Cleaners

Fleming, E. B., Nguyen, D., Afful, J., Carroll, M. D., & Woods, P. D. (2018). Prevalence of daily flossing among adults by selected risk factors for periodontal disease-United States, 2011-2014. Journal of periodontology, 89(8), 933–939. https://doi.org/10.1002/JPER.17-0572

The American Dental Association, Plaque

The Oral Health Foundation, Bad Breath

The National Center for Health Statistics, Leading Causes of Death 

Joshy, G., Arora, M., Korda, R. J., Chalmers, J., & Banks, E. (2016). Is poor oral health a risk marker for incident cardiovascular disease hospitalisation and all-cause mortality? Findings from 172 630 participants from the prospective 45 and Up Study. BMJ open, 6(8), e012386. http://dx.doi.org/10.1136/bmjopen-2016-012386

Pietropaoli, D., Del Pinto, R., Ferri, C., Wright Jr, J. T., Giannoni, M., Ortu, E., & Monaco, A. (2018). Poor oral health and blood pressure control among US hypertensive adults: results from the national health and nutrition examination survey 2009 to 2014. Hypertension, 72(6), 1365-1373. https://doi.org/10.1161/HYPERTENSIONAHA.118.11528

Batty, G. D., Jung, K. J., Mok, Y., Lee, S. J., Back, J. H., Lee, S., & Jee, S. H. (2018). Oral health and later coronary heart disease: Cohort study of one million people. European journal of preventive cardiology, 25(6), 598–605. https://doi.org/10.1177/2047487318759112

The American Heart Association, Dentists are looking out for more than your teeth

Kriauciunas, A., Gleiznys, A., Gleiznys, D., & Janužis, G. (2019). The Influence of Porphyromonas Gingivalis Bacterium Causing Periodontal Disease on the Pathogenesis of Rheumatoid Arthritis: Systematic Review of Literature. Cureus, 11(5), e4775. https://doi.org/10.7759/cureus.4775

Bascones-Martínez, A., González-Febles, J., & Sanz-Esporrín, J. (2014). Diabetes and periodontal disease. Review of the literature. American journal of dentistry, 27(2), 63–67. https://europepmc.org/article/med/25000662

Nadim, R., Tang, J., Dilmohamed, A., Yuan, S., Wu, C., Bakre, A. T., Partridge, M., Ni, J., Copeland, J. R., Anstey, K. J., & Chen, R. (2020). Influence of periodontal disease on risk of dementia: a systematic literature review and a meta-analysis. European journal of epidemiology, 35(9), 821–833. https://doi.org/10.1007/s10654-020-00648-x

The American Dental Association, Flossing

Good On You, Material Guide: How Sustainable is Nylon?