Why You Should Floss, And How Pooping Sugar Bugs Lead To Tooth Decay

My Flossing Story

To be honest, it wasn’t until I went to dental school that I started flossing my teeth. I can recall flossing and brushing my teeth rigorously on the day of a dental checkup, hoping my dentist wouldn’t notice how poor my oral hygiene habits were.

In fact, there was a time in my early 20s that I’d just had my teeth scaled and cleaned by a male hygienist. My gums were bleeding profusely and I was upset with the hygienist, because I was certain that he had torn my gums with his sharp dental instruments. Embarrassingly, what I failed to realize was that the bleeding was due to the severe gingivitis (inflammation of the gums) that I had.

My dentist used to tell me that I needed to floss and brush my teeth, and to be fair; I did… a few times after the visit. Then, I would go back to my usual routine of brushing twice a day.

Now that I’ve been practicing dentistry for the past 16 years, I find this to be all-too-common concern with the majority of the population. When I ask a new patient if they floss, the most common response (and you may be guilty of this response, too) is:

  1. A brief pause.
  2. “Not as often as I should.”

Sound familiar?

My flossing habits changed when I started to learn how much damage I was allowing to happen in my mouth, simply by neglecting to floss. Now, I can honestly and proudly say that hardly a day goes by that I don’t floss before going to bed.

In the same way, I’ve discovered the importance of people understanding the relationship between great dental health and flossing. It’s only then that I can effectively motivate my patients to begin flossing.

So, I’d like to give you the same “flossing spiel” that I present to my patients in my office. You’ll probably only read this article once, and in the same way, I also only give my patients the spiel only once. That way, they won’t feel like they’re getting a lecture every time they come to my office. But because you’ll only be hearing this once, I encourage you to take it to heart.

Part 1: How Pooping Sugar Bugs Lead to Tooth Decay

The mouth is full of bacteria, or as I tell my kid patients, “sugar bugs”. These “sugar bugs” love to eat what we like to eat: sugar. When we put sugar in our mouths, the bacteria eats the sugar, digests it, and converts it to acids and toxins. The bacteria then secrete these acids and toxins into your mouth. (I tell the kids the sugar bugs are pooping.) And then, as the acid sits on your tooth for a long time without being removed, it eats away at your tooth, and that’s how tooth decay forms.

A lot of people think that bacteria eat away at our teeth, but this isn’t the case. Think about it: would bacteria rather eat teeth or sugar? Bacteria eat sugar, but it’s the acid from the bacteria that eats away at our teeth.

Part 2: The Un-brushed Space Between Your Teeth

Most people brush their teeth every day, which protects the chewing surfaces (the front, top, and tongue sides of the tooth) from bacterial acids. However, if one doesn’t floss, between the teeth is where the bacteria are able to reside safely from toothbrush “attacks”. As long as you don’t floss, bacterial buildup remains, producing acids that eventually create cavities.

Imagine the bacteria eating sugar, then creating acid, secreting this acid between your teeth, and then remaining there, gradually causing continual damage. This could go on day after day and, in some cases, month after month, or even longer.

This is why between-tooth decay is so common for people who don’t floss. But there are even greater problems involved.

Part 3: Bacterial Acids Eat Bones, Too

Teeth are held in place by bone, and the bacterial acid that eats away at your teeth begin to eat away at the bone too. Oftentimes, I see new patients who haven’t flossed for years. Their teeth are mobile, even moving from side to side! The reason for this is that the supporting bone has been destroyed by bacterial acid. At this point, the only option is usually to extract the tooth. This is called periodontal disease (gum/bone disease), and not only does it usually end with tooth extraction, but it also leads to the receding of the gums.

I often like to show my patients an x-ray of what this kind of bone loss looks like. The bone loss is readily visible, and it helps for patients to visualize what can happen after neglecting to floss for a long time. When the patients see the x-ray with destroyed bone, the devastating effects usually hit them hard.

I can’t tell you how many dentures and partial dentures I’ve made for patients who never knew about gum disease and consequently lived for years without flossing. I like to tell my patients that I’m on a crusade to stop people from having to wear dentures. In this day and age, there are very few reasons for any young person to ever have to wear dentures, especially with the kind of dental care and education that is available.

Part 4: “But My Gums Hurt” 

People often tell me that they don’t floss because their gums hurt or bleed. What they’re failing to realize is that their gums hurt and bleed because they have acids and toxins beneath their gums!

Here’s an illustration: Imagine you have a fresh cut on your arm. If you clean the area and keep it free from debris, the bleeding will stop and, by the next day, a scab will have begun to form. On the other hand, imagine if you have a cut on your arm and every hour, you take a bottle of acid and spray the wound with acid every hour. What would it look like then? By the time the next day rolls around, your arm would be so irritated, inflamed, swollen, painful to touch, and probably bleed easily.

It’s the same thing with your gums. Bleeding and painful gums are one of the highest indicators that a patient hasn’t been flossing, and has accumulated bacterial acids and toxins under their gums. How do you stop the bleeding and pain? By flossing regularly. If a patient begins flossing regularly immediately after a thorough cleaning, the bleeding will usually stop within a day or two.

Part 5: Flossing Tips

The above patient education works quite effectively in my office to motivate many patients to begin flossing. So then, how does one floss well, and the most effectively?

There are many people who do floss, but they’re honestly wasting their time by doing it incorrectly. My tips?

  1. Ask your dental provider what the proper flossing techniques are, so you can receive the maximum benefits of flossing.
  2. Floss in the evening, after the last meal of the day, so that your teeth stay clean throughout the night while you’re sleeping.
  3. Floss, and then brush your teeth. It’s my personal recommendation, because you can first remove the “gunk” out from in between your teeth, then brush, and rinse it all away.

As a kid, I had quite a few cavities. But, ever since I’ve been flossing regularly, I hardly get cavities and my gums don’t bleed like they used to. You may have heard the adage, “Floss only the teeth you want to keep,” and this couldn’t be a truer statement.

I tell my parents that it’s like getting an oil change in their car. Regular oil changes are inexpensive, but if you don’t do them and then engine blows up, it can be quite costly. The same applies to your teeth. Flossing daily and getting regular checkups are simple and inexpensive. But if a tooth is neglected to the point that it begins to ache, it’s analogous to a car engine that has exploded. As they say, “an ounce of prevention is worth a pound of cure.”

Part 6: How About Mouth Rinses?

People often ask me what I think about mouth rinses. I think they’re great, but never in lieu of brushing and flossing. Here’s my last analogy. If you go off-roading with a truck and your car is covered in mud—sure, you can spray expensive soap and wax all over your truck. But what you really need to do first is take a rag and warm water, and physically remove the mud. Otherwise, the best soaps and waxes would be no good. It’s the same with brushing. You have to remove the bacterial gunk or plaque (comprised of bacteria, saliva, and food), and then a mouth rinse can be added as an additional benefit. Think of a mouth rinse as a method to enhance your oral hygiene, but not something that can be done to replace brushing and flossing.

Part 7: Why All Of This Matters

Like you, I don’t like getting my teeth drilled on. So, I do what it takes to reduce the amount of dental treatments my teeth need. Secondly, I like my teeth—I have a good relationship with them—and I’d like to avoid wearing dentures as much as possible. Finally, I’d rather spend my money on things that aren’t dental work.

If you can relate to any of these sentiments, then flossing every day, once a day, is the best dental care that you can give yourself and your teeth. As the saying goes, “Be true to your tooth, and they won’t be false to you.”

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Calvin Kim, DDS

Calvin Kim graduated from Loma Linda School of Dentistry in 2000 and is in private practice in the state of WA. He is passionate about exercise and inspiring others to improve their overall health through fitness. He is the co-founder and director of F5 Challenge, an organization that seeks to enrich the lives of others through the use of fitness and fellowship in a faith-enriching environment. He is an ultra runner and IRONMAN triathlete.

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