In the “good old days”, restaurants had toothpicks for customers to dislodge food particles from their teeth. What I’ve found with this habit is that people practice the “if a little works good, then a lot works better” policy. Bob was my Poster Child for this. He was a large man who had difficulty fitting fingers and floss in his smallish mouth at the same time. He was so zealous when using toothpicks that he began to recontour the interdental papilla (triangle-shaped pink gum tissue between teeth) between several adjoining teeth. That is not a good thing.
Aside from improving the appearance of a “natural” smile, each papilla also blocks the wedging of stringy or bulky food between teeth. Think about what happens when you eat spinach, an unpeeled apple, or corn-on-the-cob, for example. Leftover food particles contribute to bad breath and, if a sugar or carbohydrate, create cavities between the teeth. I’ve seen patients that develop “root surface cavities” from this, which quickly progress into a risk for a root canal.
Bob was frustrated, understandably. The first thing we recommended was that Bob switch to using a floss holder, sort of a “slingshot-shaped” aid that holds a length of floss between the two “arms” that extend from the handle. It works great for people with large hands. We also asked him to brush his teeth with his non-dominant hand. Why? Because then he had to concentrate more on technique and adapting the brush to all areas of his teeth, not scrub them on auto-pilot. Finally, Bob was given a toothbrush and told to monitor the bristles for curling on the ends. They shouldn’t curl for 3 months, unless he was scrubbing with it rather than moving the brush around to all surfaces.
The happy ending for Bob was that he realized that he didn’t need to beat up his teeth. However, the papilla doesn’t grow back. It just doesn’t get worse. Over time, we were able to modify the shape of crowns that he needed to slightly diminish the size of the spaces he’d created years before.
If you know someone who still uses a toothpick instead of dental floss, do me a favor. Show them this post.
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