How Often to Floss

We get it — you love flossing so much, you’re starting to worry that it’s becoming a problem. In the morning, before bed, on your commute, during dinner with your in-laws — it’s a compulsory habit so hard to resist that you’re starting to worry it’s taking over your life. Sound familiar?

Probably not. 

But you do know that flossing is important, and you want to make sure you are getting it in at the right frequency — especially before you visit your dentist for your regularly scheduled check-ups.  Good for you. But should you floss every time you brush your teeth? 

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There’s actually some disagreement in the dental community on how often you should be flossing. Some dentists say to integrate it into your dental hygiene routine, which hopefully, already includes brushing your teeth twice a day. For those of you type-A folks out there who brush after every meal, many dental professionals would support your efforts of flossing too. But others would disagree and say that’s a little excessive. Furthermore, it could be doing more harm than good. When it comes to flossing, whether with dental floss or a water flosser, is it possible that there can be too much of a good thing?

For that answer, we will have to defer to our panel of experts — the American Dental Association. 

According to the ADA (and you know they’re sticklers on this issue), the answer is…it could be. While the common recommendation for brushing your teeth is twice per day — once in the morning and once before you hit the hay — the ADA’s recommendation for flossing is, by contrast, only once per day. So for you compulsive flossers out there — the first step in solving a problem is acknowledging that there is one. 

Additionally, many dental professionals recommend that the best time for this once-a-day habit is during your bedtime routine. The idea is to remove plaque and food debris from between your teeth in preparation for the period that you’re not introducing any new elements into your mouth (because you’re asleep of course). This will curtail the rate that bacteria multiply in your mouth. After all, a little chunk of food is enough to sustain the proliferation of billions of bacteria for a good long while. Not the most pleasant thing in the world to think about — we know — but should be enough to serve as motivation to move this part of your routine to nighttime (if it isn’t there already).

Signs You’re Not Flossing Enough

Most of us aren’t compulsive flossers. On the contrary, most of us aren’t flossing nearly enough. A study conducted by the National Health and Nutrition Examination Survey found that only 30% of Americans floss daily, and about a third of Americans don’t floss at all. Additionally, the data collected in this study was self-reported, so the odds that some participants overstated how often they floss are pretty good. 

We don’t want to get into the graphic details about what can happen if you don’t floss enough, but suffice to say, it’s a pretty deep rabbit hole that leads to all kinds of undesirable outcomes such as losing your teeth prematurely all the way up to more serious health issues such as diabetes, heart disease, and even cancer. (Note: Research on the subject hasn’t definitively connected dental hygiene as a cause of these serious health conditions, but there are studies that have shown a link between the two). 

But if you’re not flossing enough, it’s pretty easy to tell, despite the fact that flossing is specifically meant to clean those hard-to-see areas between your teeth that your toothbrush can’t reach. Among these signs are pain, tenderness, or swelling of the gums, or if they bleed easily when you floss. That’s because your gums are already irritated by that pesky bacteria which has likely already been gathering there for some time. While a bloody mouth is not something most people enjoy, don’t let it deter you from flossing regularly. If anything, that’s an indicator that you need to keep at it. Bleeding gums should subside after a week or two of consistent flossing — if not, you may want to get the opinion of a dental professional, as chronic bleeding could be a sign of underlying, more serious issues. 

From a purely visual standpoint, another indicator that you’re not flossing enough (or properly) is receding gums. When gums recede, the roots of teeth become exposed and are not covered with as much protective enamel (unlike the crowns of teeth). This leaves teeth vulnerable to the invasion of destructive bacteria. Luckily, this stage can often be reversed if caught early enough through — surprise! — consistent brushing and flossing.  If left unaddressed, the bacteria can damage the roots of teeth. Damage to the root of teeth is both painful and expensive to resolve. It is often the reason that dentists prescribe root canals.  

Other visual indicators are discoloration between teeth or the appearance of dental calculus.  Dental calculus (or tartar) is a plaque that has hardened against the surfaces of teeth. Dental calculus generally requires the intervention of a dental professional to remove and is often the product of not flossing enough. 

Lastly, another sign of lackluster flossing skill is halitosis, or more commonly known as…bad breath. This symptom isn’t just bad for your oral hygiene — it also has adverse side effects on your dating and social life. We won’t be discussing the reasons for such here as they are obvious enough.

Too Much Flossing/Flossing Too Vigorously

Back to the compulsive flossers out there. While we commend your commitment to a rigorous oral hygiene regimen, we have some bad news for you. Most dental professionals agree that there is such a thing as too much flossing. And surprisingly, too much flossing can have the same negative consequences as not flossing enough. 

It’s not just the buildup of bacteria that can irritate them. Gums are sensitive tissue, and they can be easily irritated. Aggressive or excessive flossing can also make those poor gumlines recoil and set off the same chain of unfortunate events that a lack of flossing does — exposing the vulnerable roots of teeth to decay, causing the onset gum disease, and a whole host of other potential periodontal issues. If you wear braces, then you need to be extra careful with the sensitivity of your gums which is why proper, gentle flossing is essential for braces care. If you floss regularly and can’t figure out why despite your noble efforts, your gums are still red, tender and prone to bleeding, you might be flossing a little too hard or too often.  

Another sign that you might be flossing too often or too rigorously is the usual suspect in the world of symptoms that something is off: Pain. If you can honestly and objectively say that you’re implementing your dentist’s orders with flawless execution, but still feel pain or see swelling in your gums, you might be among the select group of folks who fall into this category. And while we commend your efforts — you’ll need to dial it back a bit. Ask your dentist for flossing tips and a demonstration of how to floss properly to curtail these types of issues in the future.

Gums are sensitive and need to be handled with care. One option worth considering is switching to a water flosser, which is less abrasive on those sensitive gumlines. Early studies have shown water flossing to be just as — if not more — effective than dental floss. Water flossers use the pressure of a focused stream to dislodge plaque and food debris in lieu of dislodging by scraping (the mechanism behind dental floss), a nice alternative for aggressive flossers. Water flossing is also one of the best ways to floss your teeth with braces.Rather than splicing gums, water flossers gently massage them, and early studies have shown that this welcome gum massage significantly reduces bleeding. And if water flossing seems doesn’t seem like it’s as intense as you are, many water flosser models offer dials that allow you to adjust the water pressure, so you can get your fix without the bloody smile. 

Other Times You Should Floss (Off-Cycle)

Certain types of foods or meals warrant an additional round of flossing. You probably already know, on some deeply intuitive level, what those foods are. They include:

• Really sticky and sweet foods like caramel or toffee 
• Foods that have a stringy composition like meat, mangos, and celery
• Foods that have small particles, such as seeds or kernels, that can wedge between teeth (we’re looking at you, popcorn).

Once a Day Keeps the Dentist(’s Lectures) Away

Steaks and popcorn aside, let’s trust the experts at the American Dental Association in their recommendation of how often to floss per day — once, at bedtime. When done properly, this low-cost, low-bandwidth habit has the big payoff of good oral hygiene, ensuring that your teeth and gums remain healthy and beautiful for years to come. Not to mention, they save you a fortune in dental procedures such as root canals or implants. It will also help you keep your breath fresh — which is never a bad thing — and make your visit to the dentist much smoother. With regular brushing, proper flossing tools, and a solid flossing technique, you’ll be on your way to a good oral hygiene regimen.

Sources:

1. Kristen Fawcett: Study says nearly a third of Americans don’t floss. Mental Floss, 2016. http://mentalfloss.com/article/81516/study-says-nearly-third-americans-dont-floss#targetText=If%20you’ve%20ignored%20your,practice%20on%20a%20daily%20basis.
2. American Dental Association: Oral health topics. ADA website, last updated 2019. https://www.ada.org/en/member-center/oral-health-topics/floss
3. Lisa Zamosky: Still not flossing? More reasons why you should. WebMD Magazine, 2012. https://www.webmd.com/oral-health/qa/how-often-should-you-floss-your-teeth 

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