Dental Education Lecture: What Happens if We Do not Floss?

In the last 3 lectures, we talk about How to Floss, Flossing and When to Floss.  When we brush and floss regularly, our teeth and gums remain healthy as shown in Fig.1.  The latter shows our 2 lower front teeth.  The single arrow points to contact point between the two teeth, below which are pink feather-thin gums.  On the either side of the gums there is a very narrow space between single and double arrows.  The space is called gingival sulcus or gum groove.  We cannot see it, but germs can enter it, form plaque and tartar and cause diseases.  As discussed in lecture Flossing, floss enters this groove to remove plaque.  Furthermore, we need to push floss as deep as possible to the bottom of the groove as indicated by the double arrow in Fig.1.

When we do not floss for a while, plaque (yellow in Fig2) begins to accumulate along the tooth surfaces between the teeth.  The gums become inflamed, reddish, easily bleeding, puffy, and recessed (arrow).  You may have bad breath.  The bottom of the groove (double arrow) somewhat remains the same as normal (compared to that in Fig.1).  The inflamed condition is called gingivitis.  If we have appropriate treatment such as professional cleaning, our gums will return to normal condition.

If we let plaque keeps accumulating (like snowball) and calcifies into tartar, gum inflammation gets worse (Fig.3).  Bad breath is more obvious.  Although you do not realize it, the bottom of the groove drops down.  This signifies more severe gum disease, called periodontitis.  Treatment of the latter is more difficult.  Before treatment, the doctor measures pocket (groove) depth.  The depth is 2-3 mm in normal persons and patients with gingivitis .  It is more than 3 mm in patients with periodontitis and may be as deep as 10 mm or more.  We will talk about gum diseases further in another lecture.

Plaque can also cause cavities (black spots in Fig.4).  Early small cavity on the left may not cause any discomfort since the cavity is far away from the nerve (in the middle of the tooth, green pointed by an arrow).  A large cavity on the right can cause severe toothache.  The large, deep cavity is very close to inflamed nerve (red).  We need to take out the latter to stop pain.  The procedure is called root canal.

Xin Wei, DDS, PhD, MS 1st edition 02/11/2009, last revision 03/20/2010