We grew up with the advice that we should visit our dentist twice a year. Our dental insurance, if we have it, has gone along with that idea, and most policies will cover two cleanings a year.
Now we often hear that we should have three or four cleanings per year. What's up with that? It has nothing to do with when the office rent is due. More accurately, it has to do with a greater scientific understanding of periodontal disease and its causes.
In the fifties and sixties, when the concept of visiting your dentist twice a year was first promoted, we didn't know anything about periodontal disease and what caused it. Decay was still rampant (there was no fluoride toothpaste and no fluoride in the water), so this was a significant step forward.
Now we know that periodontal disease is caused by bacterial plaque growing around the teeth. And we know two other important facts; timely removal of this plaque prevents progression of periodontal disease, including loss of bone around the teeth and recession, and currently, we do not have a cure for this infection.
In some ways, it is akin to managing diabetes. The better we are at controlling the infection the better our patients do, but the moment we relax and the moment we stop working, the infection returns. To make matters worse, periodontal infection typically does not hurt, so we don't get any warning that there are problems until we see recession or feel that a tooth is loose. Consequently, for those individuals that are susceptible to this infection, timely removal of the plaque is critical.
We know that after two or three months, in possibly as many as half the adult population over 40, the volume of bacteria has increased to the point where the body's immune system is overwhelmed, and the types of bacteria have changed from a population that is essentially friendly to one that is potentially harmful.
Thus, we find that if we can remove this harmful plaque every two to three months, we can prevent the loss of bone around the teeth. As a result, you may get to keep your teeth for a lifetime. Also, remember that daily flossing is just as important as brushing since the toothbrush doesn't clean well between the teeth (even powered toothbrushes). Unfortunately, our parents never made us floss, only brush because no one knew about the importance of flossing.
It doesn't matter when you floss as long as you do it at least once a day. So, pick a time that is convenient and then do it! I floss my teeth every morning as well as other times during the day. That way, I know I have done it once, and I don't have to remember to do it later. The key is to make flossing a habit, just like brushing. That way, the whole tooth is cleaned every day.