Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Brushing the teeth is a part and parcel of our daily regimen. It is not only essential to brush, but also to brush methodically and follow the etiquettes of brushing the teeth and rinsing of mouth so as to maintain optimum oral, dental and gum health. It is also essential to prevent gum and teeth disorders in the long run. So, it needs to be a holistic and comprehensive practice rather than a formality done unconsciously or in a semi-awaken state.
In the timeline of evolution, the methods and materials have changed, but the practice of brushing is passed on.
Ayurveda has not only explained ‘danta dhavana’ vis-à-vis ‘brushing of teeth’ but has also customized the toothbrushes according to one’s prakriti and need. The explanation has a touch of both ‘preventive’ and ‘curative’ perspective and is a science by itself.
Have you brushed or cleansed in between your teeth?
All of us brush. We may also think that we have brushed properly. But we are not sure how far and how better we have reached those small spaces between the teeth and got rid of the food particles or dirt sitting therein. Cleaning in between the teeth is very much essential for optimum and comprehensive oral health.
Flossing is a method of cleaning ‘in between the teeth’ using tools called ‘dental floss’.
What is dental floss?
Dental floss is a cord of thin filaments. It is used in ‘interdental cleaning’ i.e. to clean in between the teeth. It removes food and dental plaque present in between the teeth. Floss reaches all those places where a toothbrush cannot reach. It is an essential part of oral cleansing and helps in maintaining oral health.
Its use is said to prevent gingivitis and plaque buildup in and in between the teeth. According to the American Dental Association, flossing removes about 80% plaques and also benefits those with orthodontic devices. However, there is limited scientific evidence to show the clinical benefits of flossing as an adjunct to regular tooth brushing.
How many times should one floss?
It is recommended to be done at least once daily. It can be done either before or after brushing. Flossing will help the toothpaste to reach in between the teeth.
What does flossing do?
Flossing cleans the spaces in between the teeth, removes the food particles stuck therein. This in turn reduces the number of bacteria and plaque in the mouth. If the food particles are not dislodged by regular flossing, it may attract bacteria and hence infection. Plaques on the other hand, if not removed from time to time, contribute to cavities and gum diseases.
Improper flossing can cause potential damage to the teeth and gums. So, knowing the correct way of flossing is important.
Steps for proper flossing
Dental floss shall be broken off to about 18-24 inches length.
Wind the floss properly around both your middle fingers. Most of the floss should be wound leaving only 1-2 inches of floss for cleaning the spaces between the teeth.
Now, place the floss in between two teeth by holding it taut with your index fingers and thumbs.
Gently glide the floss up and down in between the teeth, rubbing it against both sides of each tooth.
See that the floss doesn’t touch the gums while flossing. This might cause scratches or bruising of gums.
Immediately when the floss reaches the gums, curve it at the base of the tooth so as to form a ‘C’ shape. With this, you will take the floss into the space between your gums and tooth.
The same steps shall be repeated as you move from tooth to tooth. Make sure to use a new, clean section of floss with each tooth.
How much time is needed to floss the teeth?
One should take about 10-15 minutes roughly to floss the teeth.
Flossing with Braces
Flossing with braces on shall take more time than flossing without them.
Waxed floss shall be chosen for this method of flossing. There will be less chances that these flosses get torn and stuck in the braces.
Waterpik or a floss threader are alternatives for waxed floss in those having braces.
Those wearing braces need to do the below said (as recommended by American Association of Orthodontists and Mayo Clinic) –
– Keep away from sugar rich and starchy foods and beverages since these foods are responsible for formation of plaques
– Brush teeth after every meal
– Rinse the mouth thoroughly
– Use fluoride rinse
– Floss regularly
Ideal tools for flossing with braces are floss threader, waxed floss, water flosser, those wearing braces and interdental flossing brushes.
Types of Dental Floss
There are many kinds of dental floss. The type of floss one uses depends on one’s preferences, space in between the teeth and if one is using braces or bridges. Some floss can be used easily in wider spaces between the teeth. The other types of floss are easier to be used when there are tighter spaces in between the teeth.
Below mentioned are the different types of dental floss –
1. Dental tape – is broader, can be helpful in those having braces, gaps or large spaces in between the teeth
2. Standard floss – is a thin, nylon strand, used in teeth which are crowded or closer together
3. Super flosses – is a floss threader which can work with braces, bridges and gaps.
– Electric flosser or water flosser – this uses water and pressure to remove plaque and food from in between the teeth. Water flossers can also be used in those having braces.
– Disposable floss picks – can be used to floss the teeth in the back of the mouth which are difficult to reach
What can happen if one doesn’t floss?
– Plaques along with bacteria in it are not removed. In this case, these bacteria start feeding on the sugar and particles of food which remain in between the teeth after eating.
– These bacteria which feed on the food, release an acid.
– This acid eats away the enamel and causes cavities.
– The unremoved plaque can get hardened into calculus / tartar. This tartar collects on the gumline, eventually giving rise to gingivitis and gum disease.
When should one floss?
One can floss at whatever time is comfortable for them to do so. Some people may prefer flossing in the morning and others do it at bedtime. In both cases it is to maintain oral hygiene.
Brush first or floss first?
It can be done either way and it is good as long as one makes sure to clean all teeth thoroughly and practice oral hygiene in a good way, each day. But according to a study in 2018, it is better to floss the teeth first and then brush the teeth than doing the other way around i.e. brushing first and then flossing the teeth.
This is because floss lifts the food particles and plaques stuck in between the teeth while brushing which is done after flossing would remove these particles from the mouth. The food particles and plaque remain in the mouth if one brushes first and floss afterwards. On the other hand, brushing a second would increase fluoride concentration in between the teeth. This would reduce the risk of tooth decay by strengthening the enamel.
According to the American Dental Association, one should floss at least once in a day and brush at least twice a day.
Limitation for flossing
Flossing should be done within limitations. One should not floss too much. Applying too much pressure while flossing or flossing vigorously can damage the gums and teeth. Flossing needs to be done more than once in a day, especially after meals.
Tools needed for interdental cleaning (alternatives to flossing)
– Waxed / unwaxed dental floss
– Pre-threaded flossers
– Water flossers
– Wooden or plastic picks
– Powdered air flossers
– Dental tape
– Tiny flossing brushes or proxy brushes
Any of these may be used but not without the opinion of the dentist. It can be customized as per your like and which you can use regularly.
Study – Flossing is associated with improved oral health in older adults
Read – Efficacy of Flossing and Mouth-rinsing Regimens on Plaque and Gingivitis: A randomized clinical trial
Read – New study suggests the ideal sequence for removing plaque – Flossing before brushing may reduce dental plaque and help maximize the benefits of cavity fighting fluoride
Flossing Ayurveda Understanding
There are many things which focus on the ‘oral health and hygiene’ which have been explained in the context of ‘dinacharya – daily regimen’ but there is no regimen which directly points out towards the explanation of flossing in Ayurveda.
But when we deeply see in between the lines, the below mentioned activities of daily regimen explains flossing –
– Danta Dhawana – brushing of teeth – Ayurveda has recommended collecting the twigs of the plants / trees like Nimba – Azadirachta indica (Neem) etc. and chewing them. We need to remember that there were no brushes in the olden days. When you chew a twig, the fibres get separated and assume the form of a brush, forming the bristles. These fibres serve the purpose of the floss since they enter in between the teeth and cleanse therein. So, Danta Dhawana is ‘two in one’ – brushing along with flossing methods.
– Kavala – mouthwash – serves the purpose of waterpik or water flossers
Along with achamana – water sipping, jihwa hirlekhana – tongue cleaning / scraping and gandusha – mouth / throat gargle and pratisarana – application of medicinal pastes in the oral cavity – danta dhawana and kavala contribute towards comprehensive oral health care protocol as a part and parcel of daily regimen.
