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April 19, 2012

How to be a better flosser — Episode 2: Anesthesiologist goes rogue and disputes dental expert

9-5-09 398

In yesterday's Episode 1 I featured flossing tips from Dr. Denis F. Kinane, professor of pathology and periodontics at the University of Pennsylvania's Penn Dental Medicine.

Even as I was preparing that post, I was mentally arguing with some of Dr. Kinane's advice but I decided not to sully his points with my twaddle.

I figured I'd wait till today to take the stage and make a fool of myself.

Without further ado, then, here's my own two cents worth of commentary.

1. I say floss before brushing — that's the oppposite of the good Dr. Kinane's advice. In a Wall Street Journal interview he told the paper's Heidi Mitchell, "The typical regime would be brushing, flossing, and rinsing. Flossing cleans out places where the toothbrush can't reach."

I can only speak for myself but the thing that keeps me coming back to my dental floss every night — OK, OK, I'll be honest, almost every night, sometimes I'm just too tired to bother or I get a flashback to when I was a boy and would fake brushing my teeth, only to realize I don't even have to fake it nowadays, I can just blow it off — right before bed is the promise of the bits and pieces of the day's food (TMI? I couldn't agree more but it's too late now) that flossing removes, much to my amazement and disgust.

When I brush my teeth first, most of those bits and pieces get dislodged and subsequent flossing reveals little in the way of macroscopic detritus.

I need that feedback to keep flossing.

Dr. Kinane's contention that "Flossing cleans out places where the toothbrush can't reach" may be spot-on but even he would agree, I suspect, that it also cleans out places the toothbrush has already visited and scoured.

2. Dr. Kinane said, "You should always introduce the floss at the top of the tooth, in the gum line, and bring it down, then remove it and find an unused length for the next tooth. The old piece of floss is fully laden with plaque. You wouldn't want to use it again and spread those germs."

Respectfully, I disagree. I tried this last night for the first time and it took so much concentration and time to do that I realized I simply wouldn't bother flossing at all if it took that kind of focus.

It's all I can do to floss at all, much less be conscientious about finding a fresh foot of floss for each tooth. I suspect most people are more like me than not in this respect.

Once again, as with the order of attack discussed in 1. above, perfect is the enemy of good. Yes, as Dr. Kinane noted, "The old piece of floss is fully laden with plaque. You wouldn't want to use it again and spread those germs." — but jeez, it's my plaque, so how bad can it be if some gets on my other teeth?

Besides which, if you think about it for a sec, flossing only gets the surfaces between teeth: what about the lingual and buccal aspects, both of which are laden with plaque under the gum line that neither floss nor toothbrush will likely ever reach?

No, I say just be satisfied that you flossed at all — move the goalposts, declare victory, and go to bed.

It occurs to me that Dr. Kinane's kind of been a straw man throughout this whole post, in that he doesn't even know it exists.

I'm gonna remedy that once it goes up, and hope he'll have a moment or two to offer a rebuttal I'll be honored to share here.

Bacon floss?

You say you want some?

No problema.


April 19, 2012 at 10:01 AM | Permalink


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Two minds without a single thought...or is that with a single thought...
Anyway. I agree. Last night during my dental hygiene routine I was thinking about this. I've tried reversing the order but I just don't like the idea of brushing my teeth to a pristine state then flossing the particles out and dragging them over my newly clean choppers. After the brushing, if you do a vigorous swishing of mouthwash or just plain water, you're bound to flush out some of the plaque you just loosened up.

While I'm at it, I'd like to put in a word for the best hand-powered toothbrush I've ever found, the Oral-B with the recessed white bristles in the center and the blue raised bristles along the edges and tip end - don't know the name of it. Colgate also has a good one built similarly - they're great for getting the gumline crud. For toothpaste I like Ultra Brite (they should really call it Ultra Bite) which is probably hideously abrasive but boy does it get the teeth spotless. Cheap, too.

Posted by: Flautist | Apr 19, 2012 2:48:51 PM

I floss with a "flosser", a centimeter of dental floss held taut by a C-shaped plastic dealio. He's telling me I should chuck each flosser after each tooth and use a new one? Not so much.

I also agree with floss, then brush. I find that when I floss some of the stuff I get doesn't actually stick to the floss but has just been moved around the tooth. A subsequent brushing then removes this stuff.

But my degree is in computer science, so what do I know?

Posted by: Nathan | Apr 19, 2012 1:25:17 PM

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