Floss Before Brushing
Posted2 months agoActive2 months ago
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Oral HealthDental HygieneFlossing
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Oral Health
Dental Hygiene
Flossing
The article argues that flossing before brushing is the most effective order for oral hygiene, sparking a discussion among commenters about their personal habits and the evidence behind the recommendation.
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My completely uneducated guess is that it's marginally useful for people with good teeth (shape, spacing) because debris doesn't accumulate as easily, and brushes are effective.
For my case (crooked teeth, very narrow gaps) it's a great helper to get out the debris, morsels of food etc. that the brush can't get out.
Edit: I forgot to mention, when I was younger, I used to snore and breathe through my mouth a lot. I think this has also negatively affected my teeth.
My wife and I have an almost identical routine and diet, we use the same brand electric brushes, always twice a day, and usually have coffee together. However, she's not had many dental problems, but I've had to go to the dentist tons this year. Oh, incidentally I also knocked my front teeth out in a cycling accident.
Since reading that I've not stressed about missing the odd brush here and there. I've also been more conscious how I brush. I stopped flossing because my gums seem quite sensitive to it and it doesn't have great evidence of effectiveness. I use a inter-denture pick/brush occasionally when needed. This all seems to have improved things for my teeth considerably, my dentist now saying they're really clean - and ironically stopped suggesting I floss more.
I wasn't joking in my previous post about the cycling accident that destroyed my front teeth, except that it happened 20 years ago. This year the crowns I had fitted failed so I've had those removed and implants installed. It's been very painful, I left replacing them probably 10 years longer than I should have. Yesterday I got a temporary bridge on the implants, which I can't use for biting. Still 2-3 months away from having the permanent new crowns fitted.
So I floss during brushing. One pass with the toothbrush, floss, second pass with toothbrush, rinse.
In my opinion, it doesn't really matter which you do first, as long as you rinse well after each step. I brush first - get most of it with the brush and rinse, then get the rest of it with the floss and rinse.
2. Brush without toothpaste.
3. Floss
4. Brush with toothpaste.
Flossing feels not that different from following up toothbrushing by rinsing (bad): it's removing a bunch of the amazing good stuff the toothpaste is designed to deposit.
What does an "oral microbiome" even mean? I understand what it means in the literal sense, but would a person's mouth be dysfunctional if it were hypothetically devoid of microbes? Is there an accepted healthy oral microbiome composition?
There's not really a 'good' time to use mouthwash. Maybe an hour or more after a meal, if you're in a rush - but no sooner than that, as the tooth enamel will still be softened by the food.
So, mouthwash before toothpaste. Or do as I do, and use mouthwash intermittently when in the bathroom, to boost the time there is fresh fluoride inhibiting bacteria on my teeth and gums.
Most importantly, don't rinse after either - same idea.
Dentists don't usually do any of the cleaning, that's the job of the dental hygienists.
I also rinse throughout the day whenever I can. It's not a routine for me as much as a habit along with generally always having plenty of water to keep things moving and clean.
Even fluorided mouthwash is about 100x less fluoride than toothpaste.
Rinsing at other times is good, though.
(a study linked in the article)
https://pubmed.ncbi.nlm.nih.gov/29741239/
I was a bit confused about why it would matter, but then realized I brush, then floss, then use a fluoride rinse, which isn't really addressed by the study. If you didn't use a rinse or a fluoride floss, presumably the toothpaste from brushing would be more likely to get into the areas between your teeth after flossing.
If you use a fluoride rinse or fluoride floss I'm not sure it would matter much, or brushing first might even be better, because it would remove material to make flossing more effective. Maybe?
Drinking water << mouthwash << toothpaste (assuming all are "fluoridated").
Edit: I missed the study linked at the bottom.
I floss after brushing, just because brushing removes a lot of particles. If I floss before, there is just so much more flossing I need to do to get everything out. I learned another thing recently, to use a proper brushing technique, I think it's the modified Bass technique. I also make sure to let the bristles go underneath the gum line.
(My second thought after typing that was "I suppose I could just ask an LLM though")
- Brush no less than 15m before eating
- Do not brush until 45m+ after eating
I don't fully understand the science, as I'm not a dentist, but it's something related to the way that things stick to/are absorbed by enamel and dentin.
I believe water is the exception here, you can drink water and then immediately brush. You should not brush and then immediately drink water though. You want the toothpaste to stick around and form a barrier.
I cannot recommend enough Jordan Expand floss. There are probably other brands that have these but that’s just the one I know.
The amount of shit this floss scrapes out is like an order of magnitude more than regular floss. Going back to plain floss feels like you’re not even flossing, it just glides over without really doing anything.
Brush first thing in the morning (before your first meal/drink, other than water), and last thing at night (well after your last meal).
Plaque acid is at its lowest, so this approach results in the least damage to enamel from brushing. (Amongst other reasons.)
For a similar reason, only have a thorough brush in the morning, and a mild brush in the evening.
Once that outer layer of enamel is breached, it will never be as resilient again.