With all the talk about flossing lately, we thought it would be fun to reach out to DentistryIQ and RDH readers to find out what your patients—who sit in your chair, and look you in the eye—tell you in all seriousness about why they don’t floss.
Yes. Dental professionals have heard all the excuses and then some when it comes to their patients flossing. From religious reasons—the Pope told one patient he did not have to floss—to entrepreneurial reasons—one patient said he uses floss for fishing—to the standard, “It hurts and makes my gums bleed!”—flossing is the thorn in many a dental professional’s side.
Now sit back and read on to confirm … you are not alone. Everyone’s patients give excuses, both creative and mundane. Many of you commented, “I could go on forever with the excuses I hear.” You may not have even heard the “best” excuse from any of your patients yet. So brace yourself!
The “medical” reasons
The ones who don't floss are usually the same people who don't want x-rays taken but will get in a tanning bed, don't want any fluoride but will smoke and vape, are allergic to latex but wear rubber flip flops, ask if we use filtered water as they dispose of their Monster energy drink can, and say the cavities they have are because "The last baby I had took all of my calcium."
I had a patient tell me he was allergic to floss. I asked what kind of a reaction he experienced and he said, "My fingers turn blue."
One of my patients doesn't believe in flossing because she thinks it makes her gums worse. She thinks it pushes the “stuff” into the gums and makes them bleed more.
Some people are afraid their crowns/fillings/veneers will fall out if they floss. I explain if they are so loose they come out when flossing they need to be replaced or recemented.
"My teeth are too close together to floss."
I asked an 18-year-old male going off to college to promise me he would floss regularly. His response? "’I’m sorry ma'am. I can’t make promises. I’m commitment-phobic."
“Because it's just so gross when I floss." Wow. Really!? That is the exact reason you need to floss!
"Flossing makes me gag."
One patient told me flossing was counterintuitive because wedging something between her teeth daily would clearly make then come loose over time.
"The floss stinks after flossing."
Use your hands much?
"I just can't get my hands that far back in my mouth."
"My hands are too big."
"I have sausage hands."
"My nails are too long," or "I just had my nails done."
It's amazing how many adults do not know the correct way to hold and use floss. Have you ever tried flossing with it wrapped around your pointer fingers? When I give my patients a piece of floss, this is how most of them hold it, and it's just awkward! No wonder people say it's too hard!
“It's too difficult.” After I ask patients to show me their technique, I realize that’s much of their frustration. Others say they’re doing good just to get their teeth brushed, so I recommend that my patients floss while they’re watching TV.
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Oh, the kids!
I work in pedo and wish I had a dollar for every kid who said they ran out of floss.
"My mom never buys it for me."
One seven-year-old told me he's too busy because of school and baseball.
Really folks?
I had a patient who swore he had increased his flossing to twice a day since his last visit. When I addressed the many issues in his mouth, he said seriously, "Oh, well, I must have been using the old floss from the back of the drawer."
"I ran out of floss."
"I don’t feel anything between my teeth," or "I don’t feel anything caught in there."
"My last dentist told me I didn’t have to do it."
"But I brush really good."
"Yes. I floss once every six months, before I come see you."
"No one has ever shown me how to floss." This from a patient who I have seen every six months and have done extensive oral health instruction to include flossing for the past several visits.
They tell me they lost their job and have no reason to have good oral hygiene anymore.
"It's hard," or "I'm too busy." It takes a whole 30 seconds out of your day, people.
I ask if they floss, and they usually say only when food gets trapped. My patients know we’re a team. If I see something needs improvement, I make recommendations, but it usually isn't floss.
They don’t like to floss. I don't ask why. I give them alternatives.
"My hands are too dirty." Soap anyone?
"I’m too lazy," or "It's a hassle."
“I lost the floss you gave me.” Ummm, really? They do sell floss in stores, you know.
"The floss shreds."
Flossing is obviously a job just for dental professionals
"I floss twice a year and you do it for me."
"That's your job."
"I leave it for the professionals."
"I just let you do it."
"It gets done twice a year when you do it. I don't want to wreck your good work."
"I can't see in there like you can."
"That's why I come to see you every three months, so you can floss for me."
"I get them flossed twice a year when I come to the dentist's office."
And of course, flossing is such a time/energy sucker
"It takes too long."
"My job keeps me too busy," or "I don’t have time to floss or brush."
So many people just outright admit they’re lazy and don’t want to do it. Well OK then.
I had a patient tell me he used to do it before bed but now he’s addicted to Candy Crush.
"I forget in the morning and I'm too tired at night." Yes, flossing does take a lot of energy.
“I remember for two weeks after my cleaning then I forget.” I recommend soft picks. They go right along with exercising and eating properly. We can educate our patients but we have no control over compliance.
"Well, I did it for like a week after I was here last time and again yesterday."
On a more serious note
An RDH columnist weighed in with some food for thought: “I never ask about flossing, I left that non-compliance model a long time ago. Too much bashing my head against the wall. You are setting patients up for failure. Most patients do not floss and they do not like it. I ask about interdental cleaning, ‘What is working for you for cleaning between your teeth?’ It shocks patients and often changes their attitude. Together we review things that have been shown to work just as well if not better than floss. I then let the patient choose. Floss is an option but it is not the only effective way to clean between your teeth. I think the best excuse that I ever heard during the years I recommended flossing was, ‘I’m afraid it will remove my crowns.’"
