Flossing is really the only way you can thoroughly clean and maintain the hygiene of those difficult to reach areas between your teeth.
However, quite often some of us experience some pain when flossing, and you probably asked yourself if this is normal or if you should be worried.
In this article, we will explain all the different reasons why you would feel pain when you are seemingly doing what should eliminate such pain.
Understanding your tooth structure
The first thing you need to understand is the structure of the tooth. All human teeth are similar in their anatomy. They are composed of a crown (that is the part that appears in the mouth) and a root (that is the part that is embedded in the bone and gums).
Both the crown and root are composed of several layers.
The crown layers
- 1The Enamel: The outermost layer, and the hardest substance in the body. Insensitive and made almost entirely of minerals as Calcium and Fluoride. The enamel is responsible for protection of the tooth against the oral environment.
- 2The Dentine: Which is the main mantle of the tooth. The dentine is present in both the crown and the root, and is quite hard but still sensitive. It is essentially the first layer that feels pain and alerts you of the presence of a problem.
- 3The Pulp: The innermost and most sensitive layer of the tooth. Also present in the crown and the root, and is responsible for nutrition and sensation of the teeth. It is also unfortunately responsible for feeling the pain when flossing between teeth, due to being inflamed, decayed or fractured.
The root layers
- 1The Cementum: A protective covering around the dentin of the root, and serves as an anchor for the teeth to the bone.
- 2The Periodontal ligament (PDL): A group of fibers that attach the root through the cementum to the bone surrounding it.
- 3The Bone: Which is not part of the tooth itself, but a key factor in the pain that you experience, as we will explain later.
Reasons for pain when flossing
Now that we’ve explained the full structure of your teeth and what layers are responsible for what sensations, it will be much easier to understand the following.
Transient reversible pain
Let’s start with the easiest cause of pain. This is caused because you have been too rough and abrasive with flossing. This resulted in a vibration in the PDL which is full of nerve endings, and caused an immediate sensation of pain. This is often momentary and subsides very quickly.
A very popular cause for pain when flossing between two teeth is inflammation of the gums, either generalized (where you would be feeling the pain everywhere) or localized (where you would be feeling pain when flossing one tooth).
When the gum is inflamed, a number of chemicals are released by your body, which find their way to the heavily innervated PDL. So when you floss, these chemicals burst and irritate the nerves causing this pain.
This is usually accompanied by bleeding as well.
A crack is a minute line that separates the layers of teeth. Of course when this crack is only in the enamel, you would feel no pain but if it finds its way to the dentine or the pulp, the situation becomes different.
When you floss, you are moving the cracked part away from the body of the tooth. So the crack line opens and fills with saliva and bacteria, resulting in pain. This of course happens on a microscopic level and needs an exceptionally skilled dentist to figure out.
It goes without saying that a cavity would cause pain if left untreated. When you try to clean that cavity from food remnants using floss, it is quite natural that you feel pain.
A faulty restoration can be the cause of pain when flossing around crown or fillings. This could be a result of one of two things:
Unfortunately, it could not be worse than this. An abscess is an infection, which is essentially a sac full of pus. This could either happen in the gums (known as periodontal abscess) or around the tip of the root due to infection of the pulp (known as periapical abscess).
In either case, the levels of chemical irritants sky rocket, and even the slightest touch to the tooth (let alone heavy, vigorous flossing) could set of a chain reaction with severe pain as the unfortunate end result.
Abuse of string floss
Of course it is great that you care enough to floss, but don’t overdo it. Dentists advise that you floss 2 or 3 times per week, no more. When you floss more than the recommended amount, you will eventually – inadvertently of course – injure the gums and the PDL.
Over time you will develop gum disease and as you know by now that pain while flossing is directly linked to gum disease.
Hot tooth syndrome
This is a term we use to describe sever pulp or PDL inflammation. In this case, the patient feels severe pain while even taking a breath, so it is highly expected to feel quite some pain when flossing. A rare occurrence but quite severe.
Don’t ignore pain when flossing, see a Dentist!
So as you can see, the flossing act which we could imagine takes a lot of your time could actually be causing you severe pain. It is best to seek help from your dentist as soon as you encounter the first signs of pain in general, and pain when flossing in particular.