Realsmile Dentistry Miami Beach

In case you have any doubt, it takes both a toothbrush and some dental floss to get a really clean and healthy mouth. Brushing with a fluoride toothpaste cleans the broad surfaces of your teeth and brings cavity-fighting minerals into your mouth. Flossing removes bacteria-filled dental plaque and food particles from spaces between your teeth where a toothbrush just can’t reach. But which one should you do first?

We won’t keep you in suspense: Either way is fine — there is no conclusive evidence that doing one before the other will keep you healthier. However, dentists have identified various advantages of starting with one vs. the other. But remember: Whichever way you start, the important thing is to do both — every day!

Brush Teeth Before Flossing

In order for flossing to improve oral health, it has to be done every day. So before you decide whether to brush or floss first, here’s one important question to ask yourself: Which way is more likely to form a habit that you will stick with? For most people, it’s probably brushing first and then flossing. Why? I call it the “yuck factor.”

The reason you brush and floss in the first place is to remove dental plaque — a soft, sticky film clinging to your teeth that’s teeming with bacteria. There are hundreds of different species of bacteria in plaque, some of which cause tooth decay and gum disease. Both of these diseases can cause pain, lead to an ever-increasing need for dental treatment, and eventually cause you to lose your teeth.

It’s important to note that plaque left on teeth more than 24 hours is more hospitable to the disease-causing (pathogenic) species of bacteria. This is why it’s crucial to break up these bacterial colonies at least once per day. Pathogenic bacteria are more likely to thrive just beneath the gum line, where there is less oxygen. Your toothbrush bristles are not as effective as floss is for cleaning under the gum line, or in the areas between your teeth.

If you start with flossing, your floss will pick up a lot of plaque that could have easily been removed with brushing. As you maneuver the floss around your mouth, your fingers will come in contact with this sticky mess as it collects on the floss and you may just say, “Yuck — forget this.” On the other hand, if you clean most of the gunk off beforehand, you can floss your teeth without coming into contact with very much plaque at all.

Also, if your teeth are covered in plaque while you are flossing, it’s possible that the floss will become so dirty that you will simply be moving plaque around — maybe even pushing some of it into the spaces between your teeth that you are trying to clean — rather than removing it. So it’s better to get rid of as much as you can and then use your floss to focus on those hard-to-reach little spaces.

After removing the majority of the plaque with your toothbrush, your mouth will feel much cleaner and you may be tempted to pass on flossing altogether. But don’t skip it! If you want the best possible oral health, this is just not an option. We dentists know this not only from our own clinical experience but also from scientific research.

A very interesting study was done in 2008 at New York University involving 51 sets of identical twins. In each pair, one twin brushed and flossed while the other twin just brushed and didn’t floss. After two weeks, the twins who did not floss had significantly more of the bacteria associated with periodontal (gum) disease.

My own research has yielded similar findings. While studying the relative effectiveness of different flossing methods, my colleagues and I found that no matter which type of floss was used, there was a significant reduction of plaque and bleeding gums (a sign of gum disease) in all the participants who flossed daily.

So I will leave you with this thought: If flossing just once a day for a few minutes would help you keep your natural teeth for life…why wouldn’t you do it?

Floss Teeth Before Brushing

Daily flossing is something I always recommend to my patients, because I often see the bad things that can happen when you neglect this crucial oral hygiene habit. People who don’t floss definitely have more problems than those who do — the most common being tooth decay in between the teeth (also called interproximal decay), and periodontal (gum) disease.

This is especially true of people who have dental crowns and don’t take care of them. A crown (or cap) is a type of dental restoration that completely covers a damaged tooth. When plaque is not removed daily from capped teeth at the gum line (where the crown meets the tooth root), tooth decay can work its way under the crown. This is more complicated to treat than a simple cavity, and it may result in root canal problems, or even loss of the tooth.

Plaque that is not removed can harden into tartar (also called calculus), which may inflame the gums. If the plaque bacteria then attack the bone beneath the gums, they may cause a more severe form of periodontal disease that can loosen the teeth. So as important as it is to floss healthy teeth, it’s even more essential for the areas around crowns, bridgework and dental implants. What’s the best way to go about it?

I recommend flossing before you brush for several reasons. First of all, flossing will loosen anything that is stuck between your teeth so it can then be brushed away; it’s a better way to clear out the debris. And once the spaces between your teeth are clear, the cavity-fighting fluoride in your toothpaste can work its way into those small areas. If plaque or food debris is stuck in there when you are brushing, the fluoride won’t get in.

Flossing before brushing can also point out areas in your mouth that need a little more attention from your brush. For example, if you find that you are pulling out more debris with your floss in a particular area, or you see a bit of blood when you floss, these are places where you should spend more time brushing — gently, of course.

Finally, there is a concern that flossing saved for last may not happen at all. It would be different if flossing were a truly enjoyable activity. But if you are like most people and find flossing more of a chore, it may be best to get it done first — and then savor that fresh, minty feeling you get from brushing as your reward for finishing up your complete daily oral hygiene regimen. If your mouth feels fresh and clean before you’ve even flossed, you may just say…well, the heck with it.

The key is to get into the flossing habit — however you do it. In the long run, it could save you a whole lot of aggravation, pain, and money spent on dental work. And don’t forget to visit your dentist regularly for professional cleanings! That’s another key component of effective routine oral hygiene. Plus, it’s a great place to get all of your brushing and flossing questions answered.

Authored By: Sebastian G. Ciancio, DDS / Daniel A. DelCastillo, DMD
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