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March « 2012 « Mark Freeman, DDS

Archive for March, 2012

Floss First : Brush Later

Friday, March 16th, 2012

At the offices of Dr. Mark Freeman & Associates, we notice that Tooth Brushing seems to get all the attention.  It is the first thing patients are taught when visiting the dentist as a child, and almost everyone has a toothbrush and knows to brush their teeth every day.   But what about between the teeth?

Recent studies show that both caries (cavities) and periodontal disease (gum disease) are more prevalent between the teeth than on the flat tooth surfaces which face the cheek and tongue.  You might think the occlusal (biting) surface is the prime target for cavities, but there are only 20 occlusal surfaces in an average adult mouth, compared to 64 inter-proximal surfaces!  These are the surfaces between the teeth which cannot be reached with a toothbrush.  The inter-proximal tooth surface, just below the point where two teeth touch, is where most cavities begin. 

Since the gum tissue between the teeth takes minimal trauma from eating, it does not have as thick of a protective Keratinized layer as the gum tissue on the cheek and tongue side of the tooth.  Therefore, this area is more vulnerable to the acid released by bacteria creating  inflammation.   The inter-proximal gum is more susceptible to disease than the facial and lingual gum tissue.  Yet despite being the biggest target f0r cavities and gum disease, most patients spend more time on tooth brushing, rather than cleaning between the teeth.

How successful is the current brushing and flossing message?  Recent studies have shown that the average person only reduces their plaque scores by 50% with tooth brushing, despite feeling clean from toothpaste.  The concept of flossing is good, but compliance is very poor.  In the United States, only 13% or adults report daily flossing.  If the patient does floss, many do not have a good techniques and leave plaque behind.

To accurately target where the disease is more prevalent, many hygienist recommend that you clean the areas between your teeth first.  Flossing correctly is the primary daily treatment for these areas; however, many alternatives to dental floss are available.  Dental Floss still holds the top spot for inter-proximal cleaners, but triangular wooden/plastic swords and soft tipped plastic picks are available for the patient on the go.  Cleaning between the teeth on a daily basis is the most important thing.   If disease prevention is the goal, it should start between the teeth.   People should still brush their teeth, but if more emphasis is placed on cleaning between the teeth where the greatest risk of disease occurs, we will see a major decline in decay and periodontal disease.


                                                                                             Dr. Mark Freeman & Associates 
                                                                                             3290 Church Road   .  Henrico, VA   .   23233
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