Should you floss before or after brushing your teeth?

We know we’re supposed to floss every day for healthier teeth and gums, even if few of us actually do. But is there a right time to floss? And is it better to floss before or after brushing?

In the The New York Times Well Blog, even the experts disagree.

One spokesman for the American Dental Association told the Times, which was answering a reader question that it’s preferable to floss first because it’s not a fun task. The reasoning: people will be less likely to skip flossing than if they wait until after brushing.

But in the same story, another oral health specialist argued that flossing after brushing is preferable because it helps the fluoride in the toothpaste work its way between the teeth.

Sebastian Ciancio, a distinguished service professor and chair, periodontics and endodontics in the School of Dental Medicine at University at Buffalo said that while there is no difference in effectiveness, he seems to favor brush first, floss finish.

“Whether you floss before brushing or after makes no difference on the efficacy,” Ciancio told TODAY.com. “Flossing before you brush might give a sense of false [protection] and you might not brush as well.”

So, really, when’s the best time to floss?

Before, after, morning or night actually doesn’t matter. As long as you do it at least once every day, you’re going to minimize the nasty bacteria clinging to your teeth, says Matthew J. Messina an American Dental Association spokesperson and private practice dentist in Cleveland.

“I am happy if people floss at any time in a 24-hour period,” said Messina.”The bacteria around the teeth organize themselves as colonies and [flossing] stirs them up. If we get in there and stir them up every 24 hours we render them less dangerous.”

The American Dental Association recommends that people floss daily and brush twice a day.

It takes about 24 hours for plaque to form in the mouth and twice daily brushing and daily flossing disrupts the plaque, also known as biofilm, build up. Flossing allows people to rid the spaces between the teeth of bacteria, which sometimes cause cavities, but most often causes gum disease. Gum disease can cause bad breath, bleeding and swollen gums, loose and sensitive teeth and receding gums.

“People who brush twice a day and floss once a day remove enough biofilm to keep gum disease and cavities under control,” says Ciancio.

In reality, only about 15 percent of us actually floss every day — no matter what we tell our dentists.

And finally, what about waxed or unwaxed floss?

Turns out, when it comes to the type of floss, the differences in product make little difference, though string floss is somewhat more effective than those handy dental picks.

Dental picks don’t reach the contact point between two teeth where bacteria love to grow, says Ciancio.

And, yes, there’s a right way to floss. It’s important when people floss to slide the floss up to the gum line and wrap it around the tooth in a c-shape.

The need for good oral health can’t be stressed enough. A recent study from the Centers from Disease Control found that almost all American adults have cavities, a concern because of the close link between gum healths to overall health.

That’s why dentists fuss about flossing.

“Gum disease starts usually in the area between the teeth and dental decay is more prevalent between the teeth as compared to flat surfaces,” says Ciancio.

Whether flossing actually helps you live longer is unclear — people with heart disease and diabetes often have unhealthy gums, although researchers are not sure how the relationship works.
It could simply be that people who floss have healthier habits all around.