I often tell my patients that flossing may be more important than brushing.   Proper flossing reduces problems with Periodontal Disease (in lay terms: Disease of the gum and bone surrounding the teeth, i.e. the foundation of the house of teeth).   Proper flossing also reduces the possibility of cavities between teeth.  Without periodontal disease or gingivitis, healthy gums are pink, firm and do not bleed.

In order to floss well, one must floss often (preferrably after every meal) and also floss as much area as possible.

1.)  Cut about 12 to 18 inches of floss.

2.)  Wrap the ends of floss around each middle finger three to four rounds so it does not slip.

3.)  Grab the floss by each pair of index finger and thumb as to have a section of floss no more than 2 inches wide.  A short section between the two hands will allow for controlled flossing.  A flimsy long piece cannot be controlled and directed to the desired location.

4.)  Slide the floss between two teeth.  If the contact is tight, a back and forth sawing motion helps to get the floss down through the tight  contact point between the two teeth.  Note:  Excessive pressure may jam the floss into the gum which with repetition may cause injury to the gums.  The sawing motion should not be used once the floss is next to the gum.

5.)  Wrap the floss around the tooth much like the letter "C".

Visualize:  Imagine that you are taking a walk in the woods with a piece of rope and you see half-plate like mushrooms caked around the base of a tree.  In order to knock those mushrooms off the tree efficiently, you will have to wrap the rope around the tree and move the rope up and down, not back and forth (or sideways).

6.)  Slide the floss up and down to disturb the plaque colonies building up on the side of the teeth and to loosen and help remove the food particles.

7.)  The floss should go a little bit below the gum (using moderate pressure) without cutting the gum.  The best indicator of how far below the gum is comfort and moderate pressure.  If you blanch the gum with your downward pressure (if the gum looks white by pressure), it is probably too far.   Of course, careful demonstration by your dentist and then in return practice by you helps.

8.)  Remember that there are generally two teeth for each space.  Once you floss one side, then bring your floss up and away from the gum (so you do not guillotine or repeatedly cut the gum) and floss the opposing tooth of that space.

9.)  The sequence of flossed teeth for either the upper or lower teeth, should be as follows:
       a.) The back of the last tooth in the back.
       b.) The front of the last tooth in the back and the back of the 2nd tooth from the back.
       c.) The front of the 2nd tooth from the back and the back of the 3rd tooth from the back.
       d.) Continue to the other side....
       e.) The back of the last tooth in the back on the other side.
 
10.)  If your gums are not used to flossing, they may be mildly uncomfortable and/or bleeding.  This should subside within a week.  However, if it continues to bleed or hurt, please see your dentist.

Note:  With regular flossing, you should have less staining, less decay, less periodontal disease, fresher breath, pinker gum that does not bleed and a poorer dentist.

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