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Dental floss is a cord of thin filaments used to remove food and dental plaque from between teeth. The floss is gently inserted between the teeth and wiped along the teeth sides, especially close to the gums or underneath them. Toothbrushes do not clean between teeth or below the gumline. Used as an addition to toothbrushing as part of regular oral hygiene flossing can reduce gingivitis and halitosis compared to toothbrushing alone. In dentistry, floss is classed as an interdental (between teeth) cleaning aid.
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, but floss was not commercially available until 1882 when the Codman and Shurtleft Company started producing unwaxed silk floss. In 1898, the Johnson & Johnson Corporation received the first patent for dental floss that was made from the same silk material used by doctors for silk stitches. Other early brands included Red Cross, Salter Sill Co. and Brunswick.
One of the earliest depictions of the use of dental floss in literary fiction is found in James Joyce's famous novel Ulysses (serialised 1918–1920), but the adoption of floss was low before World War II. The rising cost of silk during World War II led to a further development when 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.
In the United States 10–40% of people now floss on a daily basis, (whereas almost everyone brushes) but dental professionals encourage daily use of floss in addition to twice daily toothbrushing with fluoride toothpaste.
The common advice is that flossing should be carried out once per day prior to brushing to allow the fluoride from the toothpaste to reach between the teeth. The 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 then 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, but some 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, i.e. the very cheapest type of floss has a similar impact on oral hygiene as the most expensive.
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.
Individuals who have not flossed before may be put off from flossing when they notice bleeding gums after flossing. This bleeding is often a sign that there is gingivitis (inflammation of the gums), meaning that flossing needs to be carried out regularly, not avoided - but poor flossing technique, using a forceful sawing motion, can damage the tissues and also cause bleeding.
Flossing immediately after the placement of amalgam fillings can result in an amalgam tattoo.
According to the American Dental Association, flossing in combination with toothbrushing can help prevent gum disease and halitosis. 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." A 2008 systematic review of 11 studies concluded that adjunctive flossing was no more effective than toothbrushing alone in reducing plaque or gingivitis. It has been suggested that these outcomes are caused by the rarity of proper flossing technique, although two studies found no effect of floss even among dental students. One review reported that professional flossing of children reduced dental caries risk, but self-flossing did not.
Although flossing is commonly used as a means of disrupting the oral biofilm between the teeth and therefore preventing gingival disease (gingivitis, periodontitis, etc), its effectiveness is determined by the clients preference, technique and motivation to floss daily.
Flossing has been considered a more difficult method of interdental cleaning than using an interdental brush. Interdental brushes are said to be preferred due to their one-handed method of use and time efficiency compared to flossing.
According to Berchier et al. (2008) "The dental professional should determine, on an individual patient basis, whether high-quality flossing is an achievable goal." Berchier et al. (2008) also state that "routine instruction of flossing in gingivitis patients as helpful adjunct therapy is not supported by scientific evidence".
A floss threader is loop of fibrE (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 manoeuvring before it tapers off into a pick.
Floss picks are manufactured in a variety of shapes, colours and sizes for adults and children. The floss can be coated in fluoride, flavour or wax.
History of 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 end of 1980s floss picks became mass marketed in various versions.
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