Figure 3-28.Brushing the occlusal surfaces.
USE OF DENTAL FLOSS
For most people, dental decay and periodontal
disease most often occur between or on the proximal
surfaces of teeth. The toothbrush cannot clean these
areas effectively or clean behind the last tooth in each
arch. Dental floss is best for cleaning these areas. Both
waxed and unwaxed floss clean equally effectively.
However, a patient with very tight interproximal
contact areas may find waxed floss is easier to use.
Patients who have suffered a loss of interproximal
tissues may use dental tape.
When patients are first learning to floss, they may
find it difficult to accomplish. You should assure them
that with practice, flossing will become easier. In
addition, some patients may feel discomfort and have
bleeding around the gingiva the first few times they
floss. Assure them that the discomfort and bleeding
will go away in a day or two. To ease the discomfort,
you may recommend that such patients should use a
warm salt water rinse after flossing.
To properly floss, cut off a piece of floss about 18
inches long and lightly wrap the ends of the floss
around your middle finger, as shown in figure 3-29.
The fingers controlling the floss should not be more
than one-half inch apart. Do not force the floss
between the teeth. Insert it gently by sawing it back
and forth at the point where the teeth touch each other.
Let it slide gently into place. With both fingers, move
the floss up and down on the side of one tooth, and then
repeat on the side of the other tooth until the surfaces
Figure 3-29.Floss wrapped around middle fingers.
are "squeaky" clean. Use your fingers to curve or bend
the floss around the tooth. Go carefully under the gum
line with the floss since this is a sulcus where plaque
collects. Slide the floss down until you feel resistance,
but do not go far enough into the gum to cause
discomfort, soreness, or cut the gum tissue that will
cause bleeding. When the floss becomes frayed or
soiled, a turn from one middle finger to the other brings
up a fresh section.
To clean between the upper left back teeth, pass
the floss over your thumb and forefinger of your right
hand (fig. 3-30). To see the proper position of the hands,
look at figure 3-31. The thumb is placed on the outside
of the teeth and helps hold the cheek back.
To clean between the upper right teeth, pass the
floss over your right thumb and forefinger on your left
hand. Now the right thumb is outside the teeth and the
left forefinger is on the inside.
Figure 3-30.Floss position for the maxillary posterior teeth.