Not All Floss is Created Equal

By Catherine M. Fascilla, D.D.S.

I’d like to share a recent discovery that I made while trying to demonstrate flossing to my patients. After thirty years of practicing dentistry I did not realize that not all brands of floss are equally effective at removing plaque. And how did I happen upon this revelation? ...

I thought it would be a real eyeopener for patients to see where they were missing when they brushed and flossed their teeth. We decided to promote in our office what we called the “Tarter Challenge”. If our patients allowed us to disclose their teeth with a purple stain, they would be entered into a raffle to win an electric toothbrush. The disclosing agent used in our office stains teeth blue in the presence of old plaque and red where there is new plaque. Nearly all of our participating patients experienced the same results; while most were very good at brushing, almost no one was flossing effectively.

I have to admit that this is precisely what I had expected. Over thirty years ago while in dental school, it was a required exercise for us to stain our own teeth. In an attempt to prepare myself for what I considered to be a test, I went to the restroom minutes prior and meticulously brushed my teeth. At that time, I was not someone who flossed with any regularity, but I was very confident that my brushing skills were superb and that they would compensate for not flossing regularly. That exercise changed my life. The results of my test shocked me. Not only does brushing not compensate for a lack of flossing but I was not as good a brusher as I had thought. From that point on, I developed better brushing skills, flossed routinely and as a result have been virtually cavity free and free of gum disease. This is pretty amazing for someone who as a child would get cavities by the dozen and feared losing my teeth at an early age. Needless to say, I thought this challenge would be very helpful for my patients to experience.

Once a patient’s teeth were stained and all of the hidden plaque was revealed it needed to be removed. I used this as an opportunity to demonstrate how to floss properly. I had at my disposal several samples of floss that were new to the market. Those brands grabbed the plaque so effortlessly. I was very impressed by their performance but even more so when I discovered that my all time favorite floss, the brand that I have been using for years did not work nearly as well. It took significantly more effort to wipe the tooth clean of the stained film with my favorite floss than with the other brands!

I should not have been so surprised as companies are always claiming how their brands are so much more effective than the others and I had experienced a cleaner feeling with certain brands than others. But actually seeing it and feeling the amount of effort or lack of effort involved in plaque removal really made a tremendous difference.

The brands of floss that we were sampling were Coco and Dr. Tungs Smart floss. Both are excellent products and similar in many ways. Coco advertises that it is the loofah for your smile and that while other floss simply moves plaque around enabling it to build up, Coco is made of hundreds of filaments that scrub away plaque leaving gums purified. The floss is thick, fluffy and soft, yet passes easily between tight contacts and has an amazing ability to grab plaque. It is infused with coconut oil, a natural antimicrobial and comes in a multitude of unique flavors like coconut, passion fruit, cara cara orange, vanilla bean, mint and strawberry. It is very nicely packaged and available for purchase on its website for $9 a spool (about 25 cents per yard).

Coco floss wants you to “find your passion for flossing” and to “transform your daily routine into an indulgence”. Admittedly, it is a really nice floss but expensive. Dr. Tungs is similarly textured, not as soft, almost equal in its scrubbing/grabbing ability but limited in its flavors, available in natural cardamom and activated charcoal lemon grass. It can be purchased on its website but also at Whole Foods for about 13.5 cents per yard. Both advertise that they are free of harmful chemicals, gluten free and use a vegan wax instead of petroleum based waxes but Dr.Tungs uses eco-friendly containers that will biodegrade after 365 days as opposed to hundreds of years.

Other brands we used in our challenge were Listerine Reach floss which advertises 61% greater plaque removal and Colgate floss. Both worked well but the Listerine floss is exceptional. It is a blue rubbery stretchy floss that stretches thin to pass through tight spots and grabs plaque like the coco floss. It does not have that luxurious feel to it but is readily available for purchase in drugstores and very economical at 6 cents per yard.

The floss that disappointed me was my favorite floss, Glide threader floss by Oral B. It has a very important advantage for me for my patients over all the other brands in that it comes individually packaged which is most hygienic and one end is plastic coated so that it can be fed under connected teeth. This feature allows me to use it for all of my patients, those with braces or lingual wires, those with bridges or those with periodontally stabilized and splinted teeth. It is the only one size fits all floss for my patients. The problem with Glide is that it is true to its name. It glides. It glides between tight contacts which is great but it also glides over the older more tenacious plaque making that type of plaque more difficult to remove. It is also the most expensive floss at 21 cents per piece of floss or 42 sets per yard.

As patients became aware of the differences in the ability for various floss to remove plaque those you typically use the Plackers or GUM flossers wanted to know how those devices performed and I am pleased to say that they were also very effective. They are available for purchase almost everywhere for as little as 3 cents per flosser. The only disadvantage is that they can not be used under connected teeth.

Hopefully this article provided you with some useful information. If you have never experienced the “Tartar Challenge”, I encourage you to do so. Disclosing tablets can be purchased on Amazon or at Walmart so you can do it yourself at home. Or if you are a patient or would like to be, ask us to do it for you. It just might change your life.

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