Figure 3-28. - Brushing the occlusal surfaces.
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.Continue Reading