To a lot of people, “gum disease” can sound like no big deal. After all, it doesn’t involve any debilitating symptoms but problems like bad breath and red, puffy gums that bleed when you brush or floss.
Often, you don’t realize just how big of a deal it is until the condition is quite advanced. Your gums recede. You start losing supporting bone. Your teeth loosen in their sockets. Your dentist may recommend pulling some of the most at-risk teeth before they fall out on their own.
Oh, and your risk of a growing array of systemic health problems goes up. A lot. Diabetes, stroke, heart disease, Alzheimer’s, chronic kidney disease, rheumatoid arthritis, cancer, and more become much more likely in your world.
Gum disease – a/k/a periodontal disease – is also incredibly common, affecting nearly half of all adults over age 30 and more than 70% of seniors. One reason is surely the typical American diet, loaded as it is with ultra-processed foods that contain lots of sugars and other refined carbs. These fuel chronic inflammation, which is a hallmark of both gum disease and the conditions listed above.
In fact, research has shown that when you replace those products with nutrient-dense whole and minimally processed foods, you can actually reverse the gum disease process, even if you don’t make any changes to your oral hygiene routine.
Of course, hygiene matters, too, which points to another culprit in periodontal issues: Most Americans fail to floss regularly. (More than a few, sad to say, floss only on the day they have a dental appointment – sort of like cramming for a final exam.)
Just brushing without flossing means that you leave up to 40% of your total tooth surfaces covered in sticky biofilm (plaque). It’s like washing your hands without scrubbing any part of your fingers.
And while we see the difference that flossing makes for our patients, science continues to provide evidence supporting it, as well. The most recent study was published just this past month in Clinical Oral Investigations.
Seventy-five healthy adults took part. All were non-smokers (smoking is the #1 risk factor for gum disease) with signs of gingivitis, or early stage gum disease. Each was randomly assigned to one of two groups: one group brushed twice and flossed once a day, while the other only brushed.
The periodontal health of each participant was evaluated at the start of the study and at the one- and two-month marks. Two measures of oral health were tracked closely: gingival index (a measure of inflammation in the gums) and plaque index (a measure of biofilm build-up). All received weekly oral hygiene instruction, as well.
After one month, both groups had less inflammation than they had at the start – but the reduction was significantly greater for those who both brushed and flossed.
Clearly, toothbrushing helps. Flossing AND brushing helps more.
Optimized personal oral hygiene routines in individuals without loss [of] clinical attachment [a sign of advanced gum disease]… should include dental floss as a supplement to toothbrushing in support of gingival health.
There are a couple of floss brands we recommend. The first is Cocofloss, which is especially strong and well-textured, making it really effective at grabbing bacteria. Made from 85% recycled polyester infused with vegan wax, it also contains coconut oil and essential oils that are naturally antimicrobial.
Another great option is Teflon-free Risewell floss, which contains hydroxyapatite. This (not fluoride!) is the main mineral compound that makes up tooth enamel. The floss delivers a bit to your teeth with each clean swipe, supporting their natural remineralization process between the teeth, where hydroxyapatite toothpaste doesn’t necessarily reach as effectively.
Just as important as having the right hygiene tools is using them effectively. As with toothbrushing, technique matters. If you’re not using the floss correctly, you’re not going to get all of its benefits, even if you floss every single day. Here’s a quick how-to from a registered dental hygienist:
And if you’re the type of person who tends to “forget” to floss after brushing – an easy thing to do since toothpaste helps your mouth to feel clean, even if all surfaces of your teeth aren’t – there’s a super easy solution to that problem: floss first.