Dental floss

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Dental floss is a cord of thin filaments used to remove food and dental plaque from between teeth. The floss is gently inserted between the teeth and wiped along the teeth sides, especially close to the gums or underneath them. Toothbrushes do not clean between teeth or below the gumline. Used as an addition to toothbrushing as part of regular oral hygiene flossing can reduce gingivitis and halitosis compared to toothbrushing alone. In dentistry, floss is classed as an interdental (between teeth) cleaning aid.


Dental floss

Levi Spear Parmly, a dentist from New Orleans, is credited with inventing the first form of dental floss. In 1815, he recommended that people should clean their teeth with silk floss,[1] but floss was not commercially available until 1882 when the Codman and Shurtleft company started producing unwaxed silk floss. In 1898, the Johnson & Johnson Corporation received the first patent for dental floss that was made from the same silk material used by doctors for silk stitches. Other early brands included Red Cross, Salter Sill Co. and Brunswick.

One of the earliest depictions of the use of dental floss in literary fiction is found in James Joyce's famous novel Ulysses (serialised 1918–1920), but the adoption of floss was low before World War II. The rising cost of silk during World War II led to a further development when around this time, however, that Dr. Charles C. Bass developed nylon floss. Nylon floss was found to be better than silk because of its greater abrasion resistance and elasticity. In response to environmental concerns, dental floss made from biodegradable materials is now available.

In the United States 10–40% of people now floss on a daily basis, (whereas almost everyone brushes)[2] but dental professionals encourage daily use of floss in addition to twice daily toothbrushing with fluoride toothpaste.


The common advice is that flossing should be carried out once per day prior to brushing to allow the fluoride from the toothpaste to reach between the teeth.[3] The floss is commonly supplied in plastic dispensers that contain 10 to 100 meters of floss. After pulling out the desired amount, the floss is pulled against a small protected blade in the dispenser to sever it then held between the fingers or strung on a fork-like instrument. The floss is guided between each tooth and under the gumline to remove particles of food stuck between teeth and dental plaque that adhere to such dental surfaces. The floss should be gently curved against the side of the tooth in a 'C' shape, and then wiped under the gumline (very gently) to the tip two or three times, repeated on adjacent and subsequent teeth.

There are many different kinds of dental floss commonly available. The most important variable is thickness, but some people with little space between their teeth prefer waxed dental floss as it glides more easily. Some waxed types of dental floss also contain antibacterial agents and/or sodium fluoride. The ability of different types of dental floss to remove dental plaque from between the teeth does not vary significantly,[4]:37 i.e. the very cheapest type of floss has a similar impact on oral hygiene as the most expensive.

F-shaped and Y-shaped dental floss wands
Ergonomic flosser with swiveling, disposable heads

Specialized plastic wands, or floss picks, have been produced to hold the floss. These may be attached to or separate from a floss dispenser. While wands do not pinch fingers like regular floss can, using a wand may be awkward and can also make it difficult to floss at all the angles possible with regular floss. These types of flossers also run the risk of missing the area under the gum line that needs to be flossed. On the other hand, the enhanced reach of a wand can make flossing the back teeth easier.

Individuals who have not flossed before may be put off from flossing when they notice bleeding gums after flossing. This bleeding is often a sign that there is gingivitis (inflammation of the gums), meaning that flossing needs to be carried out regularly, not avoided - but poor flossing technique, using a forceful sawing motion, can damage the tissues and also cause bleeding.

Flossing immediately after the placement of amalgam fillings can result in an amalgam tattoo.[5]


According to the American Dental Association, flossing in combination with toothbrushing can help prevent gum disease[6] and halitosis.[7] A 2012 review of trials concluded that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone. In this review, researchers found "some evidence from twelve studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone" but only discovered "weak, very unreliable evidence from 10 studies that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 and 3 months."[8][9] A 2008 systematic review of 11 studies concluded that adjunctive flossing was no more effective than toothbrushing alone in reducing plaque or gingivitis.[10] It has been suggested that these outcomes are caused by the rarity of proper flossing technique,[11] although two studies found no effect of floss even among dental students.[10] One review reported that professional flossing of children reduced caries risk, but self-flossing did not.[12]

Floss threader[edit]

A floss threader is loop of fiber (similar to fishing line) used to thread floss into small places around teeth. Threaders are sometimes required to floss with dental braces, fix retainers, and bridge.

Floss pick[edit]

A floss pick is a disposable oral hygiene device generally made of plastic and dental floss. The instrument is composed of two prongs extending from a thin plastic body of high-impact polystyrene material. A single piece of floss runs between the two prongs. The body of the floss pick generally tapers at its end in the shape of a toothpick.

There are two types of angled floss picks in the oral care industry, the 'Y'-shaped angle and the 'F'-shaped angle floss pick. At the base of the arch where the 'y' begins to branch there is a handle for gripping and maneuvering before it tapers off into a pick.

Floss picks are manufactured in a variety of shapes, colors and sizes for adults and children. The floss can be coated in fluoride, flavor or wax.[13]

History of floss pick[edit]

In 1888, B.T. Mason wrapped a fibrous material around a toothpick and dubbed it the 'combination tooth pick.'[14] In 1916, J.P. De L'eau invented a dental floss holder between two vertical poles.[15] In 1935, F.H. Doner invented what today's consumer knows as the 'y'-shaped angled dental appliance.[16] In 1963, James B. Kirby invented a tooth-cleaning device that resembles an archaic version of today's F-shaped floss pick.[17]

In 1972, an inventor named Richard L. Wells found a way to attach floss to a single pick end.[18] In the same year, another inventor named Harry Selig Katz came up with a method of making a disposable dental floss tooth pick.[19] In the end of 1980s floss picks became mass marketed in various versions.

See also[edit]


  1. ^ Sanoudos M, Christen AG. (1999). Levi Spear Parmly: The Apostle of Dental Hygiene. Journal of the History of Dentistry. 47(1): 3–6.
  2. ^ K. Bauroth, et al. Journal of the American Dental Association, Vol 134, No 3, 359–365. "The efficacy of an essential oil antiseptic mouthrinse vs. dental floss in controlling interproximal gingivitis". Accessed 15 November 2009.
  3. ^ American Dental Association, "Floss and Other Interdental Cleaners". Accessed 12 April 2010.
  4. ^ Heasman P (editor) (2008). Restorative dentistry, paediatric dentistry and orthodontics (2nd ed.). Edinburgh: Churchill Livingstone. ISBN 9780443068959. 
  5. ^ Neville BW, Damm DD, Allen CA, Bouquot JE. (2002). Oral & maxillofacial pathology (2nd ed.). Philadelphia: W.B. Saunders. pp. 269–272. ISBN 0721690033.
  6. ^ American Dental Association, Accessed 28 November 2009. What does floss do? Archived February 9, 2009 at the Wayback Machine
  7. ^ American Dental Association, "Bad Breath (Halitosis)". Accessed 28 November 2009. Archived March 6, 2008.
  8. ^ Sambunjak D, Nickerson JW, Poklepovic T, Johnson TM, Imai P, Tugwell P, Worthington HV. (2011). "Flossing for the management of periodontal diseases and dental caries in adults". Cochrane Database of Systematic Reviews (12). doi:10.1002/14651858.CD008829.pub2. 
  9. ^ Matthews, Debora. "Weak, unreliable evidence suggests flossing plus toothbrushing may be associated with a small reduction in plaque". Evidence-Based Dentistry 13 (1): 5–6. doi:10.1038/sj.ebd.6400835. Retrieved 4 July 2014. 
  10. ^ a b Berchier CE, Slot DE, Haps S, van der Weijden GA (2008). "The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review.". International Journal of Dental Hygiene 6: 265–279. 
  11. ^ Winterfeld T, Schlueter N, Harnacke D., Illig J, Margraf-Stiksrud J., Deinzer R., Ganss C. (2006). "Toothbrushing and flossing behaviour in young adults—a video observation". Clinical Oral Investigations. 
  12. ^ Hujoel PP, Cunha-Cruz J, Banting DW, Loesche WJ (2006). "Dental flossing and interproximal caries: a systematic review.". Journal of Dental Research 85: 298–305. 
  13. ^ "Floss and Other Interdental Cleaners". American Dental Association. 
  14. ^ "Patent US407362 - Combination tooth-pick - Google Patents". Retrieved 2014-04-13. 
  15. ^ "Dental Floss Holder". U.S. Patent. 
  16. ^ "Patent US2076449 - Dental instrument - Google Patents". Retrieved 2014-04-13. 
  17. ^ "Patent US3106216 - Tooth cleaning device - Google Patents". Retrieved 2014-04-13. 
  18. ^ "Patent US3775849 - Dental handpiece attachment - Google Patents". Retrieved 2014-04-13. 
  19. ^ "Patent US3926201 - Method of making a disposable dental floss tooth pick - Google Patents". Retrieved 2014-04-13.