to floss or to water pick…..that is the question!
Floss is adequate for removing interproximal plaque, but is not a very good tool, particularly compared to irrigation, for disrupting periodontal biofilms. Consider the following: 1. Tooth surfaces are not uniformily smooth. They may feel smooth to the touch, you have only to see an electron photomicrograph of cementum to realize that floss can’t dislodge biofilms from all the surface irregularities. At the microscopic level, cementum is craggy. 2. The dental col. The interproximal anatomy of multi-rooted teeth is saddle shaped. Floss misses everything in the col. 3. Facial/Lingual surfaces. Even with extreme contouring, it’s difficult to floss these surfaces. 4. Compliance. This is the big one. Even though it can’t, lets say, for the sake of argument, that floss actually could disrupt 100% of subgingival biofilms. Hygienists have been preaching/threatening/cajoling their patients for at least 50 years to floss daily, but almost no one does … and even fewer do it well enough to get any benefit from it as attested by study after study (not to mention sales data). Only 5% of the population flosses. Worse, of those, only 18% of those floss correctly. That means that just 1% of the population flosses often and well enough to benefit. So, do you put your faith in the chance that this patient will be the 1 in 100 that will floss and floss correctly or recommend an alternative that the patient might actually use? Do the math. Bill Bill Landers
Category: dentistry
