Black Triangles: Is It Time to Stop Flossing?

The chances are that if you grew up in the US you have been well instructed in the art of brushing and flossing. I have seen people in braces struggling to thread floss around the wires and elastics of the appliances and older folks who could not stitch a button on a coat be instructed to floss around their last upper molar!

Even perfect flossing and brushing can only remove 40 percent of plaque from your mouth. This is because there is a plaque component in saliva (you can’t floss this) and also on your tongue and skin of your mouth. This is why mouth rinsing makes so much sense and why xylitol makes Zellies Complete Mouth Care System amazing. Adequate amounts (6-10 grams) of xylitol daily helps make plaque slippery so the rinses can better wash your teeth. Using this system should remove 98% of plaque from your mouth – twice as much as flossing!

The problem with over-brushing or constant flossing is that it has the potential to do damage to your teeth and gums. If you beat down your gums with wooden points, brushes and floss, don’t expect them to grow back again. The pretty pink gums between your teeth will disappear – and the empty space will be a black triangle between your teeth. If you have gum recession, consider a better system to clean your mouth. Think about giving yourself a flossing holiday and your teeth may become less sensitive in a matter of days.

How much gum repair you get will depend on other factors that revolve around how well you brush them and also your body’s ability to heal. This will depend on your general health, diet, lifestyle, age, etc. You can help yourself by taking supplements and probiotics and pay attention to your diet. To help heal gums, check you have enough protein in your diet, and if possible consume some organic whole milk yogurt and cheeses every day. Xylitol can be dissolved in water as a drink to sip during the morning and this will help make your gums more comfortable and give them the best chance to heal.

***

For more information, please visit all of Dr. Ellie’s web-sites:

Dr. E Oral Health Coaching - articles, resources and videos to help you learn more
Zellies.com - learn more & order your Zellies Xylitol & the Complete Mouth Care System
Dr. Ellie.com - a great resource for learning more about oral health & Dr. Ellie

Join the conversation online on the Zellies Facebook page!



Categories: Flossing, Natural Solutions, Sensitivity

Tags: , , , , , ,

25 replies

  1. I’ve never understood the notion of taking “probiotics”, except in short-term emergency situations.

    Unless I’m mistaken, the various (often proprietary) strains of bacteria that come in capsules or in yogurt are benign, but are not strains that naturally thrive in the human gut. That is you can force a population of such bacteria by eating supplements or yogurt containing them, but they’ll quickly die off if you don’t constantly replenish. You can’t load up and expect a colony to take hold.

    Is there a lot of unambiguous science supporting this notion of loading the gut with possibly-friendly strangers? I can see there being a theory of providing some competition for candidiasis and other yeast and bacteria that multiply in unbalanced fashion, but is it proven that that occurs?

    Or is there an approach that promotes resurgence of naturally gut-occurring benign bacteria?

    • I think there will be a lot more science to show the benefits of probiotics by 2014. The human microbiome project will be further along by then and some of the latest results will have been analyzed. This project takes a fascinating look at the bacteria that compose our bodies: http://www.genome.gov/27549144

      I agree that we don’t know which probiotics work and which do not. It is just like toothpaste! Ha!

      I will try to write a blog post with regard to probiotics and oral health. The main fact is that a good digestion allows you to absorb minerals better into your bloodstream and then this results in an improved quality of body fluids (that bathe your tissues). Body fluids drain via the salivary glands into your mouth. So yes, what you eat and digest will have an effect on your mouth – not just topically but systemically ( after circulating around your body!).

      It is interesting that xylitol ( seen by the digestion as fiber) breaks down to form butyrate – and promotes a healthy digestion. This in turn may help you absorb more calcium and may promote saliva with more calcium that can better heal your teeth. The circle is complete!

      • I don’t know if you listen to Science Friday on NPR, but here is a link to an interview that they did with Jeffrey Gordon, a professor of pathology and immunology at the Washington University School of Medicine in St. Louis.

        http://www.npr.org/2011/10/28/141800414/does-probiotic-yogurt-really-affect-digestion – “They confirmed what we saw at the level of gene expression and told us that, yes, in fact, a small number of bacteria ingested can affect the properties of a gut community.” It was a very interesting interview – it certainly gave me some insight as to how these probiotics actually function.

        • This was a good review of probiotics – but remember the study was funded by Dannon yogurt! Personally I expect an organic yogurt provides far more benefit – but it is all good news – and I have recommended yogurt as beneficial for a very long time. Thanks for sending this link.

      • I don’t know if you ever listen to NPR, but this was a great interview with Jeffrey Gordon, a professor of pathology and immunology at the Washington University School of Medicine in St. Louis, that gave some insight as to how probiotics actually work in/(with!) your digestive system: http://www.npr.org/2011/10/28/141800414/does-probiotic-yogurt-really-affect-digestion – it explains how “. . . yes, in fact, a small number of bacteria ingested can affect the properties of a gut community.”

        • Thanks – that is a very interesting link. We will be learning more and more about the importance of healthy bacteria and the balancing these communities in the future. I am afraid we will look back on recent history and wonder how doctors and dentist could have exhibited so little concern for this vital component of health.

  2. Another question…

    Well, I’ve got a few black triangles.
    I’ve had extensive orthodontistry, including having my jaw cut and stretched, to correct a lifelong profound overbite that was wearing the fronts off my lower teeth and the backs off my uppers. So now I have upper and lower retainers to wear every night.

    Could these be part of why my gums are thinning? The gums seem to have stopped receding from my teeth in the past few years, but where they wrap the roots of teeth and the bone, my gums have gone from being a relatively thick, gently undulating layer, to being a thin skin stretched over the teeth and bones … sort of gaunt looking.

    My body and face are nowhere near being thin, and while I eat stuff I shouldn’t (desserts), I also eat lots of veggies and fruit and high-quality protein (beef, chicken, fish, eggs, lamb, pork), but where I used to get food occasionally stuck between teeth, I now get things trapped between a cheek and the hollow rippling gum spaces between teeth. When my tongue fails to dislodge something, I have to poke a finger in alongside my upper or lower gums to hook out a soft pea or chunk of apple or piece of peanut.

    I’ve been taking well over ten grams per day of Xylitol, in the form of hard and tablet candies since reading your book a couple of months ago. I also seem to have developed a comical obsession with testing the pH of my saliva and of things that go into my mouth… and then my saliva once again after eating/drinking whatever food or treat. The mouth seems to be ph 7.2 to 7.4 most of the time.

    So, is it possible to ever regain some of the mass of my gums? Thin, though they be, they seem pink and healthy otherwise, and I no longer have pockets near teeth to concern my hygienist and her graduated probe. Oh… I’m nearly 60, and male if that makes a difference.

    • I am sorry it has taken me a while to reply to your question – but perhaps it is good – because by now you will have been using xylitol and my system for over a month. I hope you have continued to see improvements. In some cases people have seen their gums grow back quite well. Please let us know how you are doing.Check that when you brush you stimulate the circulation in your gums – on the outside of your teeth and on the inside. You’ll need a good toothbrush for this! Nutrition is also very important for gum health – so that nutrients can travel in the blood supply to the gums – to supply healthy anti-oxidants and other nutrients to help heal gum tissue.

  3. Dr Ellie, just a quick question

    From your replies to some of your posts you mention ‘gums grow back’, is this really the case, it seems to contradict everything dentists say about gum recession being irreversible?

    Thanks

    • To give a recommendation or guess at an outcome, I’d need to know why did the gums receded -and what caused the problems? Sometimes it is trauma, sometimes aggressive orthodontic work, and sometimes from an infection such as periodontal disease and associated bone loss.I have seen some rapid repair when the problem was from trauma ( like over-flossing or use of baking soda). Things were better as soon as the trauma was stopped and a good regimen implemented. Repair may take longer and be less likely if orthodontic work caused the problems ( it depends if there is a place for the gums to grow back). If you have periodontal disease, the return to normal may take longer and it will depend on how much your gums have been damaged and how much loss has occurred. The first thing is to stop the cause ( which is usually infection or trauma) and then work on keeping the mouth really healthy for a period of about 6 months. If you are getting repair – this is a very good sign! You need to think about diet, nutrition, how you brush etc. etc.

      Dentists have never promoted that cavities can heal themselves – but they do. Few periodontists believe you can stop periodontal disease – but you can. The most important thing is to first stop the disease process – because then healing can occur. The best way to stop the disease is with xylitol. If you don’t stop the disease, you cannot heal a cavity. If you don’t stop the disease – you will not get periodontal disease to go away.

      The steps are 1) STOP the disease 2) PREVENT new disease from occurring and 3) support the REVERSAL of the problems – which may take some time. You cannot jump to the last step – and this is why you need xylitol. I hope this explains why there is this contradiction from those who do not understand the use of xylitol. It is because they know of no way to STOP or PREVENT the disease process.

  4. Thank you so much for your dental regimen. I can’t tell you how long and how many products I have tried, but still pockets and quarterly deep cleanings. I’ve only been using your system (along with your Xylitol products) for a couple of weeks, but can already tell a difference. I’ve made an appointment to get my teeth cleaned in September, so giving it plenty of time. I have two questions. First is how do you feel about using an oral irrigator? I use Hydrofloss. Also, instead of a probiotic, I eat a lot of fermented food. Your thoughts would be much appreciated. Thank you once again for your knowledge.

    • Hi Gale, I am so glad this system has been helpful! I used to recommend irrigation, but there are situations where I suggest people stop using it. I think this has a use for people with braces, or if you have trouble brushing your teeth because of a disability or arthritis etc. On the other hand, I suspect it may interfere with some degree of gum healing. I personally recommend patients STOP using any kind of hydro-floss when they are trying to get their pocketing to reduce from 4 mm to 1mm. At this end stage of the healing process ( going from good gum health to ultimate gum health) I believe you achieve better results with rinsing alone.

      Nutrition is essential for gum health. The nutrients will be absorbed by the blood and circulated to “heal” your gums. You must brush your gums – on the outside and inside of the teeth – massage them to stimulate circulation – this is very important! For ultimate nutrition, I believe we must consider 3 things:
      #1) our choice of foods ( diet – supplements as need)
      #2) digestion – do we have enough digestive enzymes? ( they can be enhanced by specific foods: pineapple, papaya)
      #3) how good is our absorption and digestive health? ( may be enhanced by fermented foods, and probiotics)

      I think fermented foods are excellent and should be included in everyone’s diet.On the other hand, probiotics and/or fermented foods provide “seeds” of healthy bacteria that we need to absorb the nutrients from out food. I think once in a while it may be useful to “add” a few extra “seeds” just to ensure we are giving our bodies what they need to flourish. I usually recommend Garden of Life Raw Probiotics – and recently they have come out with an oral health probiotic variety which may be good for you. Please give us feedback when you return to the dentist in September!

  5. Hello

    I was wondering if you could help me. I had braces for just under 2 years and when they were taken off my teeth started to move again so it was put back on within 4 months for a further 4 months. It has now been off for 3 months and i have noticed dark triangles on my bottom front teeth. It is very annoying as i wanted to make my teeth look better.

    People tell me they dont look that bad but im worried they are getting worse due to my teeth moving slightly during the day. I wear my retainer ever night (told by my orthodntist) and even sometimes during the day.

    I was wondering will these pockets continue to get worse due to the teeth moving and will my gums grow back if i use this regime?

    I have had problems with stomach ulcers in the past and do take tablets to control the acid in my stomach.

    Your advise would be greatly apprecaited

    • I am not an orthodontist, but I am a Pediatric Specialist and part of this training included orthodontics. I personally believe our training was limited and gave me enough knowledge for simple tooth movement, but not as much knowledge as an orthodontist would have. I refer patients to an orthodontic specialist because an expert should have understanding about possible problems ( like the ones you describe). Moving teeth appears simpler than it is, and an expert understands the dangers of changing tooth position too quickly or with too much force. I wonder what your orthodontist says?

      Assuming that he is OK with the tooth positions and does not feel any damage has been done, I’d suggest you definitely use this system to help your gums and teeth. They are obviously stressed and need the help that regular use of Zellies and this system can offer. I don’t know why you have stomach ulcers but I think you may want to talk to your doctor about possibly using probiotics, changing your diet, and consider every aspect of good nutrition for your gum health. If your digestion is bad, you will not absorb the nutrients your gums need to heal ( gums heal mainly from the inside out – so good nutrition is vital for you).

  6. Is the ACT fluoride with the leaf picture and “fluoride rinse” the same as the ACT fluoride with the snake picture and “fluoride mouthwash”?

    • Thank you for your question. Recently new ACT formulations have been added to the marketplace and (as you have noticed) the label and ingredient listing of the “old” one has changed. To add confusion, the ACT manufacturer added a new larger-size bottle – which may appear a better price – but the concentration in this larger bottle is 0.02% (not 0.05% of the “old” one).

      When new products come along, don’t believe claims of being “new and improved” or hope they are better, or a better deal. During the past 25 years I have been so happy with the results patients experience using the “original” products, I don’t recommend any change to other formulations. I have seen cavities repair, sensitivity disappear, gum disease, recession, and periodontal pockets improve or reverse. Bad breath is eliminated, teeth strengthen, appear whiter, and most the amazing fact is that the results are sustainable – maintained year after year, often with ongoing improvement.

      At the start of my career I tried many products in a search to cure cavities and gum disease – but with the results people get from using the Zellies Complete Mouth Care System, I recommend sticking to using the original formulations whenever possible!

  7. Hello,

    I am about to start with your system and can get all of the products from Amazon UK apart from Closys mouthwash.

    Retardex is recommended which has now been renamed Ultradex. I have noticed that it contains sodium bicarbonate. Please could you let me know your thoughts on this.

    With many thanks
    Sandie

    • Hi Sandie,

      In other countries people do the best they can with products available. Ultradex should be fine – but we need feedback to tell us the long-term outcomes after years of using these slightly different products. We encourage Facebook and Blog friends to keep in touch and let us know how your “interpretation” of the system is working over the long term.

      Trial and error was how this system came together many years ago. As a new dentist, I wanted to figure out why some patients had good teeth but others did not. I asked a lot of questions about the products people used to clean their teeth and noticed a trend. People who used original Crest (Cavity Protection) toothpaste always had good teeth. A dilute fluoride rinse added a healthy shine to teeth. After observing these things repeatedly, I discovered there was a detailed chemical profile of oral care products. Gradually I realized that this Complete Mouth Care System of products could help patients eliminate sensitivity, reverse cavities, and halt or prevent gum disease.

      I’ll agree there other factors influence oral health (diet, how often you snack or drink,etc.) but I believe home care may be the main influencing factor for tooth health long term. I beg patients not to be trapped by marketing claims and to always ask if someone suggests you switch to a new product ( even if it is your dentist or hygienist)…..1) ” do you use this product (and for how long) ….2) “does it work?”

      • Dear Dr Ellie,

        Thank you for your reply.

        I am seeing the hygienist in November so am going to start your system slowly as you suggested to someone else.
        I have two root canal fillings and will have to make my mind up if they fail in the future whether to have them redone or to have implants. My dentist did the root fillings herself and said she would not do them a second time because she hasn’t got the specialised equipment so would refer me but it would cost
        more. I have heard that if they are redone a second time there is more chance of them failing.

        I will have to make up my mind whether to pay a lot of money for a second root filling and risk that failing and wasting money or just going ahead with an implant.

        Please could you let me know your thoughts on having implants.

        With many thanks
        Sandie

  8. Dear Dr. Ellie,

    I have some spaces between my back molars that get a LOT of food stuck between them. I feel it there an want to floss several times a day to get it out. After reading your blogs, I wonder if I am making things worse. Should I just leave the food there more often? It doesn’t seem right to do that, either, but I don’t want to damage my gums by flossing too much. Last time my pockets were measured, there were a couple 4′s but everything else was less.

    I have been focusing a lot on xylitol and diet and brushing already and have been using parts of your system…although I’m on and off with the mouthwashes. I am 37 with no cavities or gum disease. The hygienist did mention that perhaps my gums were a little more irritable due to breastfeeding. (??)

    Thank you,
    Julie

  9. Hi Doc!

    When you say massage the gums, can I use my fingers to massage them? If so, how many minutes per day should I aim for?

  10. Dr. Ellie,

    My dental team says nothing can be done about black triangles…that gum and bone grafting will not have enough circulation or sticking power to remain in place. They say bonding and veneers can’t be made to cover the problem, nor are they conducive to cleaning. All the dentists with whom I have spoken say widening crowns would look terrible and they would be very temporary due to the cleaning issue. A couple of dentists I’ve seen say I should wait for technology to advance to where we are able to grow gums. One dentist even said the only solution would be to have a false pink strip put over the triangle to simulate the look of healthy gum. That sounds like an extremely poor way to treat the issue. Please tell me your advice.

    • Now everyone has told you the situation is hopeless – why not try my suggestions? I have no idea how old you are, how healthy or unhealthy you are, or how severe your gum recession is – but the first thing I’d suggest is for you to decide what you think caused this problem. Maybe it is years of chronic gum disease, bleaching, use of baking soda, mouth breathing, smoking, excess acidity in the mouth, GERD etc. etc.etc. If the cause of the problems was in the past, then that is great – but if you are drinking soda – that needs to stop if you want results!

      I’ll assume you are living a healthy life, have a great diet, and are committed to using my complete system ( I suggest that you order a kit from http://www.Zellies.com and ensure you have the correct products at the start). For at least a month or two I suggest you supplement your diet with a great whole-food vitamin/mineral supplement and also a digestive Probiotic suitable for your gender and age. I like Garden of Life brand – and suggest you take these for at least 2 months. The idea is to improve the absorption of nutrients from your gut, which in turn will support your immune system, and the immune system will send healing “ingredients” around your body to your gums. This is why you need to massage the circulation in your gums ( see below). Gums heal from the inside out – not by flossing them. You really should try to stop flossing for this 2 months period – to give your gums a chance to heal.

      It is very important to massage your gums with a toothbrush – make small circles right up on the gums – above the teeth. You have to stimulate circulation in your gums ( or else blood does not flow – and gums cannot heal). An electric brush is OK once a day – but before bed put some personal effort to this with a nice manual brush – working to massage all around the gums on the inside and outside of your teeth. Please take some photos for yourself – and let us know what you see happening in 8-10 weeks on this system. I believe that many others would be interested to hear feedback. Best wishes to you on your journey – how cool would it be to go back to your dental team and amaze them?

  11. I really want to begin your teeth cleaning system but I am worried about one thing. I use a sensitivity toothpaste. If I use a regular toothpaste, then after a few days I get horrible tooth pain when I have even the slightest temperature fluctuations to my teeth. So I am scared to stop using a sensitivity toothpaste. I have confidence that using your teeth cleaning system will, in the long run, help me with the tooth sensitivity problem. But I don’t think I can handle the pain and discomfort of stopping the sensitivity toothpaste until I get to that point. Is there any way to remain on a sensitivity toothpaste with this system and still get the same results?

    • First i’d suggest you start using Zellies after everything you eat and drink. (Try to keep drinks to meals.
      Next experiment by rinsing with ACT during the day. Then start using Closys before you brush with Crest Cavity Protection paste, and rinse the paste off with ACT. Finally add in the Listerine step – and let us know how this worked! Stop flossing for a few days until your teeth feel better!

Leave a Reply or Ask a Question

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: