You know it's coming: that moment you always dread. Your hands are already gripping at the edges of the dental chair in squirming anticipation: Your dentist is about to drop "the F (Floss) bomb."
And, lo and behold, she does, finishing your exam with a simple question: "Have you been flossing regularly?"
Listen, I'm a dental student. I LOVE everything tooth-related. I even woke up on Black Friday for a sale on an electric toothbrush! But even I miss a day of flossing here and there. It happens. I'm busy, days are long, time is limited, and whoops, I forgot to floss. So believe me when I say I sympathize with the dreaded nagging to floss your teeth. Don't dentists get how much of a pain that is?!
Well, like I said, I'm a dental student, and, from the doctor's side of the chair, I can say that we do get it! We're human, too. And, we care about you. We care about your smile and your oral health. We care about your oral habits and your systemic health. And we care to let you know that you have power when it comes to preventing oral disease!
I know, I know, it sounds like I'm getting carried away. Floss is just a little piece of string, after all. Except, it's a little string that can make a major impact. Over five hundred bacterial species can reside in the plaque in your oral cavity. A toothbrush can start to keep things clean, but what about that bacteria below your gum line? When that multiplies, you can start to develop chronic inflammation, irritation, and even gum recession and tooth loss, a process you may know as gum or periodontal disease. Uncontrolled periodontal disease may even increase risk associated with diabetes, cardiovascular disease, and systemic inflammatory conditions, because your mouth, a highly vascularized orifice, is intimately integrated with the rest of your body's organ systems. Though you may think periodontal disease is something you'll never experience, the reality of its prevalence is startling: The CDC reported that over 47 percent of American adults had periodontitis, and over 70 percent of adults above the age of 65 had this disease.
But even with those statistics, periodontal disease may sound a little extreme for your healthy body. So let's take a step back and think about your teeth in general. What causes tooth decay? Acid acting on the enamel surface. And where is that acid formed? In the dental biofilm, the site where bacterial metabolism is taking place. While brushing your teeth is a primary step in managing your oral health, flossing -- the added removal of bacterial build-up -- is a necessary second step in your oral hygiene routine. Besides, who wants to walk around all day with a piece of lettuce stuck between two molars or with a particle of food breaking down to cause bad breath?
Listen, I hear you when it comes to flossing. I don't always want to do it, and I have never enjoyed my dentist's well-meaning lectures to make flossing a habit. In fact, according to a survey in 2014, only four in 10 Americans really do floss every day! But, as much as I understand the dread of that flossing conversation, I am going to keep the conversation alive. I am going to call out to my medical colleagues and friends in the nursing community. I am going to holler to teachers and teenagers. Because not a lot of medical ailments are preventable, but periodontitis is. The systemic complications that come from periodontitis are, too, preventable. So let's keep this flossing conversation alive until every single one of us can say we used the F (Floss) word today.
The doctor said she would live in a nursing home, confined to a wheelchair, crippled by pain; that was thirteen years ago. Instead, Mirissa D. Price is a 2019 DMD candidate at Harvard School of Dental Medicine, spreading pain-free smiles, writing through her nights, and, once again, walking through her days.