Tuesday, September 7, 2010


"He who rejects change is the architect of decay. The only human institution which rejects progress is the cemetery" - Harold Wilson

There is no doubt that in order to survive we must make changes along the way. As research reveals more information to us, we must adapt our behaviour so that we can incorporate these findings into our life style. For example, smoking was not an uncommon habit amongst pregnant women just 30-40 years ago. Imagine that! It was socially accepted then and you won't have to go very far to meet a woman who tells you that she smoked all through her pregnancy and breastfeeding period in the 60's or prior to that. Can you think of anyone you know today who would do that? (At least publicly)

Change is essential to our survival.

Let's take brushing and flossing.
Why do we need to floss on top of brushing- isn't brushing enough?
What are the benefits of flossing?
Why do we need to do either?

A paradigm shift has occurred that must be discussed to answer all of the above questions.

Brushing and flossing is not just about your oral health but about your OVERALL HEALTH AND LONGEVITY.

Research now shows what the dental profession has known for years. Your general health is directly connected to the state of your oral health. Diabetes, cardiac conditions,high blood pressure, premature birth rates, etc. are linked to a higher incidence of periodontal (gum) disease. Researchers from NYU in a National Health and Nutrition Examination Survey compared the incidence of being at high risk for diabetes among people who had gum disease to those that did not. 93% of adults with gum disease met those guidelines as opposed to 63% of individuals who did not have gum disease. That is a significant difference.

So the WHY should we brush and floss has changed to include benefits for our overall health in addition to the past known reasons such as prevention of gingivitis, gum disease, cavities, bad breath and eventually loss of teeth. Not to mention the social suicide one commits when walking out the door with anything less that minty, fresh breath. That usually is the motivating factor for young teens and adolescents and works well when encouraging them to take better care of their oral hygiene...

The next question becomes HOW to brush and floss optimally.
The previous blog entry gives a detailed description of how to optimally brush your teeth, so today we will focus on flossing. And the answer to the question- is flossing necessary? Yes, because it removes bacteria from areas that a brush cannot reach. Aside from helping to prevent cavities, flossing helps prevent bad breath!
Take a 12-18 inch piece of floss. Wrap it around the middle fingers of both hands and place the floss below the contact point of two teeth using the thumbs to push it down. Make the letter 'C' around a tooth and floss the part of the tooth that is under the gum (not the gum between the 2 teeth) Then wrap the C around the adjacent tooth and floss the area under the gum of that tooth with an up and down motion with gentle pressure. Continue around the mouth including the back of the last tooth. Keep changing the floss portion used as you advance. You are essentially flossing the part of the tooth that is under the gum and is between two teeth. This area is not accessible to toothbrush bristles. See this link for proper illustrations regarding flossing.

Flossing is like exercising. We all know it's good for us but what stops us from doing it daily?

Lets go through all the 'reasons' why we don't floss daily -despite what we promise ourselves we will do as we leave the dentist's office with 'clean teeth' and feeling freshly motivated by the hygienist. That will help us change our habits

I have no time to floss- Set aside time for flossing when you know you won't be rushing out the door(AM) or are too tired to do it(PM). You know when your daily routine will allow you the extra 60 seconds it takes to floss. Also,it may sound weird at first, but flossing while doing a sedentary activity like watching TV is an excellent way to get started.

I don't know how to floss- Everyone in our office is happy to spend the time to show you how to effectively floss. It is also a routine part of your re care visit with us.

My gums bleed when I floss so why bother- If you do not have underlying gum problems that require definitive treatment then this bleeding will stop after a few days of regular flossing. Less bacteria, less bleeding. Remember that healthy gums don't bleed.

I just can't use the floss- Then try the flossers that have a handle. It helps patients that have a dexterity limitation or are beginner flossers

My floss catches and tears- Then buy super floss and have us check your dental work to make sure all margins are healthy and don't need replacement.

I forget to floss everyday- Don't worry, you'll get there. I'm thrilled that you are flossing a few days a week. Add another day every few weeks and in a few months you will be flossing every day. A tip that works wonderfully is to simply floss before you brush.

I just don't want to floss- OK, but be prepared for increasing expenses and time commitments at your dentist's office to treat those conditions arising from a lack of flossing. You may also find yourself with increased risk for general health issues.

REMEMBER- Self improvement is all about changing.
Habits take about21 days of consistent and daily effort to change or create
  • Be realistic about setting goals.
  • Post reminders on your bathroom mirror
  • Celebrate small advancements
  • Buy new floss and tooth brushes
  • Be enthusiastic when putting forth the effort
  • Adjust expectations
  • Practice patience
  • Practice constructive discontent


I learn a lot from listening to my patients. All of the above information is based on communications that they have had with my team and myself about the challenges they have had with flossing over the years. We are here to help you take the best possible care of your health and well being.

I would like to leave you with two recent conversations I had with patients that have struck me as the 'paradigm shifts' that are necessary to accomplish lasting change of any sort.

Tim (not patient's real name) was in for his re care appointment a few months ago. I always look forward to his visits because it gives me an opportunity to check out what's happening in his field. We talk about all kinds of interesting stuff from what's going on in his industry, psychology, raising kids, following our passions and anything else that is 'hot' that day. At the end of his appointment, I was showing him flossing techniques when he said, 'You know, I was at the gym with my trainer the other day and he was spotting me while I lifted weights. He wanted to push me and so asked me to do a few more for him. It just hit me at that moment- No...I will not do it for you. I will do it for ME! That's when I just shifted my paradigm It's the same about flossing. I am going to do it for me."

Ken (not patient's real name) was in just last week for his re-care appointment. He felt that he had "slacked off" during the summer but was very motivated to get back to regular flossing and wondered out loud why it was so "hard" to stay on the course. I asked him why he flossed? He said for his health. Obviously that was not enough to get him the results that he was looking for. So I told him that studies showed that flossing regularly could add up to 6 years to his life. And that's in addition to the other health benefits that the habit brings along. Ken has 2 toddlers and I suggested that he visualize being there not only for them but for their children as well. This kind of purpose makes it so easy to set a goal and stay on course. The purpose becomes bigger than us and it drives us to accomplish anything we set our minds on.

So find a purpose that works for you and go for the goal.
'til next time,
Be well,
Live well,
Do well.