The Effect of Flossing on Dental Caries: A Critique of Current Literature

Dental caries is a multi factorial disease due to minerals imbalance in the tooth structure. One of the main etiological factors causing dental caries is dental plaque [1]. Occlusal and proximal surfaces of the tooth structure are more susceptible to plaque accumulation [2]. Within the dental plaque, sufficient amount of cariogenic bacteria could utilize the available carbohydrates inside the oral cavity in order to produce lactic acid and demineralize the tooth structure [3]. Evidence showed that caries prevalence in young individuals is more related to the occlusal surfaces. As for adults, this prevalence is higher in proximal surfaces [4,5]. Interproximal plaque was found to be more acidogenic than other surfaces [6]. The routine tooth brushing cleans off the dental plaque from accessible tooth surfaces [7]. However, toothbrushes are not designed to clean the interproximal areas between teeth. Due to toothbrush limitations, dental floss was introduced as an inter dental cleaning tool in 1819 [8]. The dental floss is developed to go between the teeth and get the interproximal plaque off. Eventually, with the correct habitual flossing process, this should eliminate, or reduce the amount of proximal caries [9].

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