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Comment by tmp12938 | Hacker News Reader

As if you didn't need another reason to floss! Always.

>Flossing has quietly lost its place among recommendations for daily health, at least as prescribed in the Dietary Guidelines for Americans, which are issued every five years by the U.S. departments of Health and Human Services and Agriculture.

and

>"In large epidemiological studies, the evidence for flossing turns out to be fairly weak," says Tim Iafolla, a dentist with the National Institute of Dental and Craniofacial Research, which is part of the National Institutes of Health.

https://www.npr.org/sections/health-shots/2016/08/02/4883786...

I wonder then what is an adequate means of reducing plaque. I never get cavities, but my teeth are starting to see the signs of having problems with plaque, so I wonder what a good option is.

Brushing your teeth?

Well yes, but that's not enough to prevent plaque buildup, especially in hard to reach areas of your mouth. Apparently floss isn't either, so I'm wondering what is.

I've been in a similar situation(never a cavity) and started getting some warnings from my dentist about sore gums and decay years ago, which led to some self-studies. They have gone something like this:

* Reducing the source of decay is #1, especially acidity. Swap out coffee, tea and soda for water more frequently and you get a huge boost immediately.

* If #1 fails you can still aim to reduce acidity over time with e.g. having more milk or immediately brushing with toothpaste. Milk's proported function in "building healthy teeth" is probably more attributable to this rinsing property than any of the nutritional aspects.

* I experimented with primarily flossing over brushing. Even though the crevices were clean, gum soreness went up overall. The opposite way around, primarily brushing with occasional flossing, the plaque can build up somewhat, but it does not result in pain.

* Yes, supplementation can do something here. I went in cycles on and off Vitamin D3, and pain went up off it and down once on it again.

Anyway, I have managed to quit the beverages, and occasional brushing with less occasional flossing seems to be doing the trick.

Milk is slightly acid though. You'd think as a rinse it would be somewhat less ideal than water.

> If #1 fails you can still aim to reduce acidity over time with e.g. having more milk or immediately brushing with toothpaste.

They say don't brush with toothpaste immediately - you're taking softened enamel and scrubbing it off with the toothbrush.

https://www.mayoclinic.org/healthy-lifestyle/adult-health/ex...

For me it's a combination of below gumline wear due to plaque and grinding - doesn't seem to be acid based.

Xylitol is supposed to be good for oral health. You can buy 5 lbs of it for $30 on Amazon and swish with a teaspoon of it right before you go to bed. That 5 lbs of xylitol will last one person more than a year.

https://www.amazon.com/XyloSweet-Non-GMO-Sweetener-Granules-...

Just a note that dog owners should be aware that xylitol is deadly to canines. [1] Xylitol is found in sugarless gum, toothpaste, some foods, and some deodorants.

[1] https://vcahospitals.com/know-your-pet/xylitol-toxicity-in-d...

Dental hygiene is terrible in Japan, but people LOVE Xylitol gum here.

Horrible, horrible advice. Brushing, especially with a non-electric toothbrush, comes no where close to cleaning out all of the debris between one's teeth. The problem seems to be that all the studies were too short to make definitive conclusions on flossing's effects.

Using an oral irrigation device like a Waterpik can get the particles between the teeth and in pockets under the gum line that brushing and flossing don't get. You'd be surprised, if you don't Waterpik regularly, at how many particles are dislodged into the sink even after brushing with an electric (Oral B) toothbrush.

I find Flossing helps to scrape plaque off the tooth surface between teeth but isn't that great at particle removal. Remember that plaque is really a biofilm so by brushing and flossing you break up the biofilm. The oral irrigator removes the food particles (and blasts the bits of biofilm knocked loose,) from between the teeth. Follow up with some sort of mouthwash now that the biofilm is disturbed.

After many years of flossing, and with my (very-conservative) dentist's tentative approval, last year I switched to using small interdental brushes [0] each time I brush, which is more convenient. I rinse the little brushes every time and use new brushes once per week. I use two sizes (fine and wide) because two particular teeth are tightly packed together. At my last checkup my dentist said it was fine to keep using the interdental brushes in lieu of flossing.

[0] https://www.amazon.com/gp/product/B00873H7AS (I get nothing from this link; like me, you might need different sizes).

Any thoughts on the environmental impact on floss vs using and disposing these brushes once a week?

I use dental floss regularly, but I have been thinking that it's sure odd that I throw away little pieces of (what I think is) plastic everyday without thinking twice about it.

> Any thoughts on the environmental impact on floss vs using and disposing these brushes once a week?

I'm guessing that to a first approximation it's probably a wash, or very close to it — and the brushes might even be better than floss in terms of total weight and volume of plastic per week. (I haven't tried measuring either quantity.)

While certainly a larger initial investment, if disposable waste if your concern you should try a waterpik.

https://www.amazon.com/Waterpik-Accepted-WP-660-Aquarius-Flo...

They work great, it's roughly as good as flossing (depending on who you ask it's worse or better), and it's easy with nothing to throw away. There are cheaper models as well, that's just the one I have and it works great.

My dentist is adamant that waterpik is not a substitute for flossing, rather a solid bonus.

Personally I'm not a fan of flossing. Always seems to make my gums bleed. I much prefer using a waterpick it's gentler and seems more effective too.

If flossing makes your gums bleed, you're not flossing enough.

No, this is not a "No True Scotsman" sort of argument or some sort of sarcastic joke; that's really what it means. It should stop bleeding in just a couple of days of regular flossing. If it doesn't, your mouth may be indicating another problem.

That was my experience too.

When I first started flossing I'd get some bleeding (in no small part because my lack of flossing before caused the gum at the bottom of the tooth to be inflamed). Bleeding is very infrequent now.

I personally use those plastic flosser sticks. I cannot figure out just the string. But I floss once a day every day and have for years.

Just remember to floss each tooth twice in a V shape. You need to do both sides of the tooth and the bottom.

Either not flossing enough or using bad technique.

I'm not a big flosser, so my gums always bleed a bit when I do it myself, but my dental hygienist always flosses me after a cleaning and she never makes the gums bleed.

Sorry but I'm not going to start flossing when I can use a Waterpik instead. There's just no need for it.

Depending on your genetics and general dental health, yeah, flossing isn't always required. Not saying "don't floss" but I made other changes to my dental habits (how i brush, etc) and rarely need to floss - dentist says everything's fine. Obviously though if your dentist is saying 'floss more', then floss more.

There are also little dental picks you can get that you can use to clean between teeth without flossing, though I find them hard to use. If you're having trouble with regular flossing definitely ask your dentist for alternatives.

I have an alternative, as mentioned in the comment. I use a Waterpik.

It's gentler than sticking a piece of plastic string between your teeth and more effective at getting trapped material and plaque out.

Either you are flossing wrong or you haven't gotten over the hump or you have gum disease. I'd talk with your dentist.

Having said that, I love my waterpik. When I floss and rinse, it still flushes things from between my teeth that flossing couldn't get rid of. I highly recommend both!

Also about a third of the brands of tooth floss use potentially carcinogenic PFAS (Teflon like substance).

Good grief I had not seen that news. They literally put that crap everywhere. Thanks for the heads up.

I also had seen this, have you found any good substitutes that provide a non awful experience? I tried Tom's floss as a replacement but it was very thick and non a good substitute.

I've enjoyed Radius Silk Floss (https://madebyradius.com/collections/all/products/natural-bi...) but I haven't tried Tom's so I can't really compare.

I’m using Dr Tung’s which uses bee’s and other vegetable oil derived waxes. The flavoring is also naturally derived.

It’s not as smooth as others (but smoothness = less effective at removing plaque), so it may take some getting used to (esp if the tooth gaps are small).

A mouthwash with cetylpyridinium chloride (CPC) might help with gum health. Crest makes a version with CPC and Hydrogen Peroxide that was recommended by a dentist at one point.

https://en.wikipedia.org/wiki/Cetylpyridinium_chloride

Edits: spelling + link.

I've had good results with chlorhexidine moutwash and toothpaste (curasept).

Flossing really strike me as an American thing. You can buy dental floss anywhere, but only in the US do you hear it's the most important thing ever, probably because of the really high sugar consumption.

Americans place a ton of emphasis on oral care. Most of middle class and above get braces as children; many going as far to get corrective procedures (affectionately referred to as 'headgear').

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