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Fig. 17. Less than one-third the total number of nylon filaments contained in the right kind dental floss. Each separate filament, when properly used, is potentially capable of scraping off or dislodging some material and the many spaces between them can hold many microscopic particles, bacteria, etc.

Necessity For Cleaning The Tooth Within The Interproximal Gingival Crevices

So far as proximal caries of the enamel is concerned, it is only necessary to clean the proximal surfaces of the tooth above the gingival margin or the papilla. We have seen that from the very earliest stage of periodontoclasia there is bacterial film and other foreign material on the surface of the tooth within the gingival crevice (Figure 12) and that this material is responsible for the initiation of the very earliest lesion and for the continued progress of the disease. To prevent the beginning and progress of the inflammation and

suppuration which characterizes the disease it is necessary to clean these areas of the teeth within the crevices. This can be done well enough with the right kind of dental floss mentioned above but it cannot be done in any other practical way now known. The surfaces of all teeth within the interproximal crevices of contacting teeth, and those within the distal or mesial crevices where there are no contacts, must be cleaned. This is accomplished by carrying the floss down to the very bottom of the crevice, holding it against the tooth and drawing it slightly endways and outward so as to scrape the surface. The bacterial material is dislodged and much of it is held and removed within the spaces between and around the filaments (Figure 17) of the floss.

Detailed Directions For Cleaning The Teeth Right With The Right Kind Of Dental Floss

While different people may develop their own technic and manipulations for cleaning their teeth with dental floss, the following procedure is probably the most practical and effective:

1. Cut off a piece of floss about 2 to 3 feet long. 2. Wrap one end with 2 or 3 turns around the first phalanx of the right index finger, for the purpose of anchoring or holding it. ( Figure 18 ) . 3. Bring the floss over the end of the right thumb which is also held against the finger around which the floss is anchored. (Figure 18). 4. Grasp the floss with the left hand and bring it over the end of the first finger of that hand. Thus a length of floss, about 1 inch long, is held between the thumb of the right hand and the first finger of the left hand. (Figure 18 ( 1 ) ) . 5. Now with the thumb inside of the cheek and the finger inside of the mouth, the floss is carried to the very bottom of the gingival crevice back of the last right upper tooth, drawn slightly endways through the crevice and crossways outward across the distal surface so as to scrape off and dislodge the soft bacterial material on the tooth within the crevice and outwards. 6. Holding the floss in the same way, pass it into the next interproximal space. Carry it to the bottom of the posterior gingival crevice and clean the mesial surface of that tooth. Now, before withdrawing the floss from this interproximal space, clean the distal surface of the other tooth in the same way. Then withdraw the floss and move on to the next interproximal space, etc., until the proximal surfaces of all teeth have been cleaned. 7. In passing the floss between contacting teeth it is not forced directly in and out. It should be held over the contact and drawn gently and slightly back and forth endways. This allows the low-twist, unwaxed floss to flatten and pass between the contacting teeth with the greatest ease.

Fig. 18. Best way to hold floss in cleaning the teeth. For upper right (1). For upper left (2). For lowers (3).