Dental Questions: Why Does Flossing Make My Gums Bleed?

A common complaint among patients is that “Flossing causes my gums to bleed, so I don’t floss.” In actuality, the reverse is true: not flossing on a regular, once-a-day basis will cause the gums to bleed when flossed occasionally. Plaque and tartar buildup beneath the gum surface leads to inflammation which in-turn causes bleeding. When you use a toothbrush, the bristles can effectively clean the tops and sides of the teeth. However, the interproximal space (space between two teeth) is impossible to reach with brushing alone.  Hence, we recommend using some sort of dental cleaning device between the teeth once a day. Floss, Butler Soft Picks, handle flossers and water picks can all be used to “brush” this space. There are a number of great options- even if you don't like traditional dental floss!

Floss and Flossing Alternatives

As you probably know, flossing is one of the best ways to preserve gum health, prevent decay and ward off tartar and plaque between the teeth. Even though this information nearly universal, only about 50% of Americans floss daily. Where does the discrepancy originate? For many, flossing either takes up too much time or doesn’t fit in with their schedules. Others simply don’t like using dental floss. With this in mind, we wanted to take a moment to introduce different types of floss, flossers and flossing alternatives. We are sure you can find a product that fits in with your dental care needs!

This Oral-B floss is both waxed and has a threader built in. 

Although there are many different brands of traditional dental floss on the market, they all generally produce the same results. The real difference comes from preferences in packaging, flavoring and texture. For patients who have found floss too “sharp” or “cutting” to use, we suggest looking for a waxed variety. Furthermore, those with orthodontic appliances, bridges or permanent retainers might benefit from floss with an attached threader tip. While these varieties may be more expensive than using a reusable threader, they offer added convenience and ease of use.

GUM Soft Picks are great alternatives to traditional floss.

Beyond traditional floss, there are a number of great alternatives designed to clean between your teeth. Many patients enjoy single-use flossers with handles, as they are portable, disposable and easy to use on-the-go. These devices are also great for kids who don’t yet have the motor skills to use regular floss. Others may prefer flossing picks, such as GUM Soft-Picks. These tree-shaped products expand below the gumline to remove plaque similarly to regular dental floss. Because of their shape, they great for cleaning around orthodontic appliances as well.

A Typical Water Flosser

Water flossers such as the Waterpik systems can also be utilized in cleaning between the teeth. Research suggests they are not as thorough or effective as other flossing methods, but they still represent an improvement over doing nothing. There are certain scenarios where water flossers can be a benefit to patients with periodontal disease, but this needs to be evaluated on an individual level. As with any oral hygiene product, make sure to follow the manufacturer’s recommendations when using water flossers. Regularly changing tips and cleaning water reservoirs prevents the buildup of harmful bacteria and biofilms.

At Thousand Oaks Family Dentistry, we know that our patients are presented with a number of choices in dental home care. We want to give you the information to make the best choices for your personal needs. If you would like to know more about flossing, toothbrushes, toothpaste or any other dental products, please give our office a call!

What's in a Toothbrush?

“What type of toothbrush do you recommend?”

- A question heard daily at dental offices around the world. Between TV ads, flashy packaging and nearly miraculous promises, there seem to be an infinite number of variables on the simple brush. Fortunately, picking a great toothbrush is easy and straightforward. There is no need to go out and buy the priciest or latest model; as long as you keep some simple principles in mind, you are sure to make a great choice.

When picking out a manual toothbrush, the most important factors to consider are brush head size and bristle stiffness. In general, a smaller brush head will allow you to better access the more difficult-to-clean areas of your mouth. This is especially true for young children, who have much less room to accommodate a large head. Also, make sure you are using a toothbrush with soft or (at the most) medium stiffness bristles. Stiff and extra stiff options can actually cause damage to your enamel and gum tissue, particularly if you tend to brush with a lot of force. Beyond size and stiffness, the brush you use should be a matter of personal choice. Make sure to use a toothbrush that is comfortable to hold and easy to maneuver all over your mouth.

For those looking to “upgrade” their brushing experience, our office recommends switching to an electric toothbrush. For the average patient, electric toothbrushes offer a more complete cleaning experience by taking the guesswork out of duration, proper motion and amount of force necessary. While it may be possible to achieve the same level of clean with a manual brush, electric variants simplify the process while simultaneously making it harder to “cheat” on brushing time.

When shopping for an electric brush, we recommend looking for the best deals available on brushes with timers and force sensors. Big box stores tend to have the best prices, particularly on two packs (for you and a loved one!). Most brushes will fall into either the sonic (vibrating) or the spinning (mechanical) category. We recommend picking whichever motion you think you will like the best. As with manual brushes, the most important factors are brush head size and bristle stiffness. So long as the brush comes with a reasonably small and soft head, any mechanical motion will be beneficial to your teeth and gums.

If you have any further questions about toothbrush choices, do not hesitate to call our office. Any of our staff members can offer great perspective on what models have worked best for them personally. We are more than happy to make recommendations and suggestions with all your home dental hygiene choices!

Video Blog on Home Hygiene

Greetings, my name is Dr. Kari Ann Hong, and I have a family dentistry practice where I see patients from all age groups.  In my practice, I help educate my patients about what they can do at home to help care for their teeth.  

The first topic of discussion is what patients eat and drink and how frequently they do so.  Our mouths all naturally harbor a certain amount of bacteria.  A specific strain called streptococcous mutans is responsible for eating the foods and beverages we ingest and creating acid.  This acid causes a breakdown in the calcium phosphate structure of our teeth, leading to tooth decay.  Certain foods will stick to the teeth longer than others and make the teeth more susceptible to decay.  Examples of cavity provoking foods and beverages are pretzels, crackers, cereals, sodas, energy drinks, and juices.  Natural foods that come from a tree or are picked from the ground will naturally wash of the teeth much quicker after we eat it.

Every time we eat or drink something other than water, our mouth will become more acidic for at least fifteen minutes after we ingest it.  So the more frequently we eat, the more acid that accumulates in our mouths.

In order to counteract the bacteria in our mouths and the foods that stick to our teeth, it is important that we brush twice a day and floss once a day.  I generally recommend an electric rechargeable toothbrush like a Sonicare or an Oral B to all of my patients.  These electric toothbrushes are great because they help remove plaque build up better that we can with a manual toothbrush.  Also, they have timers on them to encourage us to brush for a full two minutes.  I recommend that my patient split their mouth up into four quadrants, and spend 30 seconds on each quadrant.  If you choose to use a manual toothbrush, then I recommend a soft tooth brush.  A harder tooth brush can adversely abrade the gum tissue or the tooth surface with extended use.  Place the tooth brush at a 45 degree angle to the tooth surface.  Make sure to gently massage the tooth and focus on where the teeth meet the gums, because this is where the plaque likes to collect.  

I recommend flossing or using a hygiene tool to clean below the contact of the teeth at least once a day. The idea behind flossing is that you want to get the floss between the gum and the tooth, by wrapping each tooth you have just flossed between in a C-motion.  For the butler soft pic, you just need to get it below the contact area.

In terms of what toothpastes or mouthwashes to use, I have a couple of suggestions.  Any fluoridated toothpaste will be sufficient to clean the teeth.  In patients that have a high risk of tooth decay, I will often recommend an additional  tooth paste to be brushed on with a dry toothbrush, after regular tooth brushing.  CariFree gel and MI paste are two of my favorite products for tooth remineralization.  Both products have calcium, phosphate, and fluoride that help to rebuild tooth structure.  

For mouth washes, I like over the counter ACT Fluoride rinse for those prone to tooth decay.  For those that are prone to gum disease, I recommend Listerine, which is anti-bacterial.  CariFree also makes a mouth wash that is pH neutral and has the same calcium and phosphate as the gel.

Finally, if you like to chew gum, then you can also fight your bacteria at the same time, by finiding a gum with xylitol. Xylitol is a plant derived sugar that prohibits the bacteria in our mouths from producing acid.  Studies have shown that 5-8mg of xylitol a day in a chewable form helps protect our teeth.  

If you would like more information about what you can do to prevent tooth decay and make your teeth healthier, contact us for a new patient exam, where we will go into your specific needs in detail!