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Do you floss? Or, like many people, do you always seem to find a reason not to?

A 2008 survey found that only 49% of Americans floss daily, and 10% never floss. That’s most unfortunate, dentists say, because flossing is even more important than brushing when it comes to preventing periodontal (gum) disease and tooth loss. 

"If you were stuck on a desert island and a boat could bring only one thing, you’d want it to bring floss,” says Samuel B. Low, DDS, professor of periodontology at the University of Florida College of Dentistry in Gainesville, and president of the American Academy of Periodontology. “But I’m convinced that the only time some of my patients floss is an hour before showing up in my office.”

Dentists say they hear all sorts of excuses for not flossing. Yet they insist that simple workarounds exist for just about all:

Excuse #1: Food doesn’t get caught between my teeth, so I don’t need to floss.

Flossing isn’t so much about removing food debris as it is about removing dental plaque, the complex bacterial ecosystem that forms on tooth surfaces between cleanings. Plaque is what causes tooth decay, inflamed gums (gingivitis), periodontal disease, and eventually tooth loss. Flossing or using an interdental cleaner is the only effective way to remove plaque between teeth.

Excuse #2: I don’t know how to floss.

Flossing isn’t easy. Low calls it “the most difficult personal grooming activity there is.” But practice makes perfect.

Here’s how the American Dental Association describes the process:

  • Start with about 18 inches of floss. Wrap most of it around the middle finger of one hand, the rest around the other middle finger.
  • Grasp the floss tightly between your thumbs and forefingers, and use a gentle shoeshine motion to guide it between teeth.
  • When the floss reaches the gum line, form a C shape to follow the contours of the tooth.
  • Hold the floss firmly against the tooth, and move the floss gently up and down.
  • Repeat with the other tooth, and then repeat the entire process with the rest of your teeth, “unspooling” fresh sections of floss as you go along.

Don’t forget to floss the backs of your last molars. “By far, most gum disease and most decay occurs in the back teeth,” Low says.

Excuse #3: I’m not coordinated enough to floss.

Many tooth-cleaning options exist for people whose manual dexterity is compromised by poor coordination, hand pain, paralysis, and amputations -- or simply by fingers that are too big to fit inside the mouth.

One option is to use floss holders. These disposable plastic Y-shaped devices (some equipped with a spool of floss) hold a span of floss between two prongs to allow one-handed use.

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