A String around Your Finger: Do We Really Need to Floss?
Review of Literature Demonstrating the Effectiveness of Oral Hygiene Methods

Microbial biofilm begins to form within seconds of thorough debridement of tooth surfaces and owing to the complexity of bacterial biofilms, biofilm associated infections are a challenge to treat.^75,76 Well-organized biofilms grow within hours and biofilm must be completely removed at least every 48 hours in experimental settings to prevent inflammation.⁷⁷ Current ADA recommendations^11,12 for oral hygiene include:

• Toothbrushing for at least 2 minutes twice daily with a fluoride-containing dentifrice.
• Clean between teeth daily
• Eat a balanced diet and limit between-meal snacks
• Visit your dentist regularly for professional cleanings and oral exams

Several methods for dental biofilm removal will be reviewed, along with evidence of their effectiveness (Figure 4).