Germs, Gingivitis, And Why You Should Floss
As far back as I can remember, I have been told that I needed to floss, or floss more often, or that if I didn't floss, bad things would happen. Bad things--unthinkable things. Nameless and mysterious things!
However, it was never explained to me WHY I should floss my teeth, or what it really had to do with anything at all. I felt that it was just something the hygienists and dentists said to each patient as a matter of course. They needed to tell you something, after all, and flossing must be the old standby when there was nothing else to say.
Eventually, my hygienist caught some cavities between my upper molars. Once again this "flossing" thing came up, and I was told that if I didn't start flossing, I'd get even more cavities. I figured they knew what they were talking about, but never thought to ask WHY. I began flossing diligently, but blindly. If this would make me have less cavities, then it must be necessary. Necessary, yet so mysterious!
I learned in school that:
- Flossing displaces destructive colonies of bacteria in the mouth
- Bleeding gums are actually caused by open sores and irritation caused by bacteria
- When you don't floss or maintain oral hygiene, these colonies grow and change
- When these bacterial colonies are allowed to grow freely without disruption, they eventually cause severe gum disease and contribute to the development of systemic diseases such as heart disease, stroke, high blood pressure, lung disease, diabetes, osteoporosis, and early death. Source here.
1. Flossing displaces destructive colonies of bacteria in the mouth
The mouth is warm and moist, and we all know what that means: bacteria! While some bacteria are beneficial, some are destructive. We'll focus on the potentially destructive here.
Bacteria occur naturally within the mouth. Like many things, they are fine in moderation. But what happens if the colonies are allowed to thrive? We get rampant bacterial growth; they start moving in, building homes (intermicrobial matrices), staying for dinner every night (carbohydrate sugars), and leaving little unwanted presents like toxins and lactic acid. In effect, they "excrete" lactic acid after munching on the foods and sugars between our teeth, and this acid--not the sugar--is what weakens enamel and eventually causes cavities.
These bacterial colonies are commonly known as "plaque," or the newer term "biofilm." It is this biofilm, along with its associated toxins and acids, that will lead to bleeding gums if not disrupted daily. If left untreated, the biofilm eventually turns into tartar (calculus), irritating the gum tissue and potentially causing severe gum disease. In addition, the constant onslaught of acid on the teeth will invariably lead to cavities.
Flossing "disrupts" their colonizing efforts and continuously inhibits their ability to build stable homes (calculus.) However, due to the warm, moist environment that they find themselves in, they re-colonize rapidly; this is why flossing every day is necessary.
2. Bleeding gums are actually caused by open sores and irritation
Sometimes, when you do remember to floss, suddenly there is blood everywhere, and you wonder what in the world is going on! Bleeding gums are not normal; in fact, they are an infection of the gum tissue. Effectively, flossing rubs against open sores in the gum tissues, sort of like pulling a scab off of a wound.
The gums are extremely resilient, but they can only withstand so much. When your gums start bleeding, it means that the bacteria have been allowed to survive and thrive for so long that the tissues just can't cope any longer.
The good news is that gingivitis is reversible . A week or two of flossing correctly once a day can completely reverse this cycle, disrupt the bad bacteria, and push gingival disease (gingivitis) back to where it should be: in articles and biology books.
3. When you don't floss or maintain oral hygiene, these colonies grow and change
Growth, of course, means that the colonies thrive and expand exponentially. However, what do I mean when I say that they can change?
Well, after a certain threshold has been reached, and when the potentially bad bacteria have been allowed to thrive, something "actually" bad happens. The bacterial environment becomes so rich and so welcoming that new bacteria may now survive and thrive that previously would not be able to do so.
In other words, the original colonies have been there so long that instead of an environment that supports potentially harmful bacteria, the environment now supports harmful bacteria as well. In effect, the chemistry has changed! New things are now possible! The problem is that these new changes are for the worse.
These "new" harmful bacteria can live without oxygen (are anaerobic)--deep in the pockets of the gums. If left untreated for months, this can lead to periodontitis (severe gum disease.)
4. When these bacteria are allowed to grow freely without disruption, they eventually cause severe gum disease & systemic diseases
Bleeding gums are a sign of gingivitis, or mild gum disease. However, over time and if left untreated, this can expand into severe gum disease, known as periodontitis (Gk. peri = "around"; odontos = "teeth"; itis = "inflammation.")
Periodontitis is characterized by extremely infected and inflamed gum tissue (shiny, puffy gums that bleed when you touch them or exude pus); wiggly teeth due to the destruction of gum and ligament tissues which hold the teeth in place; separation of teeth with increasing space between teeth; and destruction of bone in the jaw, which also acts as a stabilizing mechanism for the teeth. The jaw bone is resorbed and does not grow back.
This disease takes time. It is the result of long-undisrupted biofilm (plaque). However, genetic predisposition and drugs like methamphetamine speed this process. Eventually the biofilm calcifies (hardens) and turns to calculus under the gumline. Over time, more and more harmful bacteria (gram-negative anaerobes ) adhere to this calculus matrix. When left alone, they calcify and form yet more calculus.
This is a vicious cycle that can and will lead to tooth loss if left untreated. If left for too long, periodontitis will cause systemic poisoning and will contribute to the development of systemic disease (heart disease, diabetes, etc.) and eventually death.
*With periodontitis, self-treatment is no longer an option, and professional help must be sought as soon as possible. It is not reversible like gingivitis; unfortunately, it can only be maintained by routine dental visits--for life. *
Periodontitis and gingivitis are both, other than a few exceptions, completely preventable
If you're tired after a long day and don't feel like flossing, just remember: with practice, it only takes a few minutes! Do your very best and work on it. We're not expecting miracles here--just that you try. These things take time to remember and work into a habit. But hopefully along your floss-filled path you will now know WHY you should floss--and not just that you should.
Good luck, and happy flossing!