Question: At work, I heard someone bragging that he had just come back from the dentist and gotten a clean bill of health despite the fact that he hadn’t flossed in over a year. But when I stopped flossing years ago, my hygienist noticed right away and said I had gum recession and gingivitis. (Since then I’ve become a habitual flosser and no longer have gingivitis.) So can you really get away with not brushing and flossing? How is this guy getting away with not flossing and still getting a clean bill of health from the dentist?
Answer: Believe it or not, you CAN skip flossing and even trick your dentist and hygienist into thinking you have been flossing. But the question is, for how long can you keep them fooled, and, would you even want to?[/answer]
What’s probably happening is your co-worker is not flossing but his good brushing is delaying all the changes in the mouth brought on by not flossing. That’s because the effects of someone not flossing are not necessarily visible or measurable right away. But that doesn’t mean your co-worker isn’t doing damage.
How Your Dentist Knows You’re Not Flossing
If a pro athlete, say Serena Williams, stopped exercising, eating well, sleeping well, and taking care of her body — it’s going to take quite a bit of time before you could begin to notice she had lost some of her conditioning. It would take even longer for obesity, diabetes, heart disease, or other conditions related to an unhealthy lifestyle to set in.
It could be that something similar is happening with your co-worker. You don’t go from having no gum disease one day and then gum disease the next day.
You could also floss for a week before your appointment and maybe fool the dentist that way, since it takes about a week of flossing to make the gums stop bleeding when they’re cleaned.
Being young and healthy, having a great diet, and leading an overall low-inflammatory lifestyle can all reduce the outward effects that a dentist or hygienist would have to notice in order to be able to tell you weren’t flossing.
For those of you who read between the lines, yes, good gum health is not only about flossing and brushing. It’s also about what you eat and your lifestyle — but that’s another blog post!
You could even take this one step further and not visit your dentist and do well for a period of time.
But here’s why you wouldn’t want to do this: the whole foundation of being smart about your health has always been and should always be prevention. That is, don’t let the problem become a problem at all and then you’ll never have to deal with it.
Once it does become a problem and the signs and symptoms are visible and measurable, then you’ve got a problem that will be more difficult to address. At that point, you’ve only fooled yourself.
What Happens When You Don’t Brush and Floss
The insidious thing about not flossing is you can’t see bacteria and you can’t see them building up and colonizing in your mouth. You can’t see your body’s immune system trying to fight these bacterial invaders. Your co-worker won’t notice his body getting more and more run down — he might think it’s a normal part of aging or not even notice it at all (talk about boiling frog syndrome.)
When you don’t brush or floss, the “bad” bacteria already present in your mouth increase in numbers and begin to colonize. They establish a firm hold and a basis for pathology for causing disease.
Your body responds to this bacterial invasion the same way it would respond if you had the flu or cold — with an immune response in the form of inflammation, which is your body’s attempt to repair things by destroying the intruder.
This immune response is what keeps you safe from infections and other “intruders” in your body, but it is incredibly taxing to the body to keep up an immune response all the time.
This inflammation damages your whole body, including the fibers that connect your teeth to the jawbone and changing the shape and color of your gums. Since the inflammation is constant, your immune system is constantly working in overdrive, putting you at risk for disease.
The Health Risks of Not Brushing and Flossing
If your mouth is constantly in a state of inflammation from not flossing, your immune system is constantly working to keep the bacterial invaders at bay.
Years or even a lifetime of your immune system constantly working puts you at risk for diseases even outside your mouth, including:
Some studies have found a link between Alzheimer’s and gum disease-related bacteria in the brain. According to a University of California researcher, gum disease can cause inflammation and brain damage.
“Not only does the state of your mind predict what kind of oral health habits you practice, it may be that your oral health habits influence whether or not you get dementia,” said Annlia Paganini-Hill, who led the study, as published in the Journal of the American Geriatrics Society.
C-reactive protein (CRP) is a protein that can be measured in your blood. It appears in higher amounts when there’s swelling (inflammation) somewhere in your body.
Your doctor may check your C-reactive protein level after surgery or treatment for infections or other medical conditions.
A C-reactive protein test can also be used to evaluate your risk of developing coronary artery disease, a condition in which the arteries of your heart are narrowed. Coronary artery disease can eventually lead to a heart attack.
Gum disease begins with bacteria growth in your mouth and makes gums red, swollen, and bleed when they’re provoked by floss or a toothbrush.
The body responds to gum disease with the immune response, which is designed to attack the bacterial invaders. This immune response eventually breaks down gum disease, pulling away from the teeth, exposing the roots.
If gum disease continues to spread, gum tissues and bone is destroyed, creating pockets between the teeth that can become infected.
Researchers have determined that periodontal disease causes ED in humans based on studying penis function in rats. (Source: The Journal of Sexual Medicine, 2011)
Diabetes is a risk factor for periodontitis and extremely poor dental health may also be a risk factor for insulin resistance (often called “pre-diabetes”), mostly because it increases inflammation in the body. (Source: Journal of Applied Oral Science, 2013)
The good news is that people with diabetes can improve diabetes control by reigning in their periodontitis and improving their dental health.
Multiple studies have suggested that there may be a connection between gum disease and heart disease, both of which are associated with inflammation.
When pregnant women have serious oral health problems, their infants are more likely to have a low birth weight and preterm birth.
The reason for this is probably one of two mechanisms at play: either overall inflammation is heightened, or oral bacteria that enter the bloodstream eventually colonize the placenta, causing an inflammatory response. (Source: Dental Clinics of North America, 2013)
Sure, your co-worker sounds like he’s successfully fooling the dentist and hygienist, but I’d say, how close do you want to get to the conditions above? Why tempt your fate?
One or two nights of skipping flossing — or in your co-workers case, a year without flossing — won’t show effects for a while, especially while youth and health can overcome it.
But if you’re using this to trick your hygienist into thinking you’ve been flossing, then you’re only tricking yourself.
Mark Burhenne DDS