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Park Ave. Periodontal Assocates

FAQs about Flossing and Toothpicks

Lake in Central Park

Why floss? It’s such a drag!

The main reason to use dental floss is because floss removes the hard-to-reach plaque that toothbrushing misses. In fact, most dental decay and periodontal disease begin where teeth touch each other...at or under the contact points. And that’s precisely where the toothbrush bristles cannot reach.

What is floss?

Dental floss is composed of gently twisted nylon or Goretex threads.

Are there different types of dental floss?

Dental floss comes waxed and unwaxed, flavored and unflavored, and in varying widths: thin, regular, or wide. There is no "best" type of floss to use. Unwaxed floss is favored by many dentists because as it’s used, the nylon threads spread to absorb more plaque. Dental purists argue that waxed floss leaves a residue on the teeth, which can collect plaque more quickly.

Our feeling is that clinically it doesn’t matter which type of floss - or dental tape - you use, but just that you use it. Toothbrushing, alone, does not remove enough plaque to be effective when it comes to good oral hygiene.

Ask your dentist/hygienist, how best to use floss under fixed bridges and around dental implants.

How often should I floss?

You should floss once each day. Though cumbersome at first, flossing will take no time at all, once the skills are mastered.

How should I floss?

Use about 18 inches of floss. Wrap it loosely around your middle fingers...not your index fingers. The reason is that you don’t want to limit the range of motion of the index finger which, along with the thumb, is used to guide the floss in the right places.

With the floss wrapped around your middle fingers, guide a piece roughly 1" to 1 1/2" between two teeth. Gently saw the floss back-and-forth, passing beyond the contact point, to where the floss slides down the neck of the tooth.

Once the floss is beyond the contact point, guide it "around" one of the teeth. Avoid the triangular gum tissue, known as a papilla. A good way to picture this is to think of the tooth as a circle, and your goal is to swipe away the plaque from one half of that circle. Slide the floss gently into the space between the gums and the tooth until you meet resistance. Then, holding the floss firmly against the tooth, rotate it up and down, as if you were "shining shoes." After two or three strokes, lift the floss over the papilla, shifting your thumb and index finger so that you guide the floss around the half of the other tooth in the same area. Repeat the same motion again, removing the plaque from this tooth. When you’ve completed this, pull the floss back through the contact point and begin the process over again in the next interdental area.

When the floss becomes frayed or soiled, unwind a fresh piece from your middle finger. After flossing, it’s a good idea to rinse your mouth with water to loosen and remove any particles next to the teeth.

Would a water irrigating device help my periodontal condition?

Only in specific instances. A water irrigating device removes debris from between the teeth, known as "loose adherent" plaque. It is always good to remove this plaque, but a residual, adherent plaque can still be found on the teeth and root surfaces. Adherent plaque is not removed by water irrigating devices. This plaque - adherent plaque - can damage the teeth and periodontal tissues by causing dental caries and periodontal disease. As a matter of fact, if a water irrigating device is angled incorrectly, it may drive bacteria into the periodontal tissues…causing more harm than good.

What else helps remove plaque?

Toothpicks.The last ingredient to effective plaque removal is the use of toothpicks. We at Park Avenue Periodontal Associates, are big advocates of this old-fashioned method of cleaning teeth. Why? Because toothpicks get to those last nooks and hiding places that both floss and toothbrushing miss. Studies have shown that the most effective way to remove plaque is when all three methods of removal are used: toothbrushing, flossing, and using a toothpick.

Do I hold the toothpick with my fingers?

Holding a toothpick with your fingers is minimally effective. That’s because after reaching those in-between spots in the front teeth, it’s hard to maneuver the toothpick toward the back of your mouth, and near-impossible to clean the inside (tongue side) of your teeth. Instead, we recommend using a Perio-Aid. A Perio-Aid is a plastic tool that is specially designed to hold the toothpick in the proper angle for cleaning in between all teeth, both outside and inside. If you have periodontal disease, but do not use a Perio-Aid, ask your dentist for his/her opinion.

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