You can exercise, eat well, and be emotionally healthy, but if you don't floss, cavities could be just the beginning of your problems.
Flossing every day is so crucial to health that it's one of the questions included in the Living to 100 Life Expectancy Calculator. The tool uses parameters like diet, exercise, and health habits to determine an approximate age of death. Thomas Perls, the creator of the calculator and an attending geriatrician at Boston Medical Center and professor at the Boston University School of Medicine, said only one question on the quiz addresses flossing, but the calculator estimates that this yes or no could be worth up to one year of life. Though it's difficult to quantify health habits in terms of how many years of life they add, doctors and dentists alike assert that flossing is essential for good dental health — and dental health has long been tied to overall physical health as well.
Not flossing allows plaque, the thin film of bacteria and saliva that clings to teeth and builds up over the day, to turn into tartar, a hard deposit that can irritate and inflame the gums. The tartar can cause the gums to recede and create a gap between the gum and the tooth that could become infected.
This stage is called periodontal disease, and can destroy the bone and tissue that hold teeth in place, resulting in a higher risk of tooth decay and loss. But problems inside your mouth are just the tip of the iceberg. Gum disease has been associated with ailments in other areas of the body as well, including heart disease, HPV infection, mouth cancers, diabetes, and kidney failure.
Perls said that several studies have shown an association between gum disease and heart disease. The mechanics of how they're linked are unclear, and some scientists point out that the research still has yet to show an independent association between that two. Still, poor or nonexistent flossing habits do lead to severe gum disease, a significant risk factor for mouth cancers.
A 2013 University of Texas Health Science Center study that analyzed 3,439 people found that periodontal disease has been found to be "an independent risk factor of oral HPV infection," even when smoking has been taken into consideration. Oral HPV can mutate normal cells in infected skin and cause mouth cancers, according to the CDC. Periodontal disease causes extreme inflammation in the gums and surrounding tissue, and has been found to be linked to other diseases associated with inflammation, including kidney disease, Alzheimer's, and diabetes, according to US News. (This does not mean periodontal disease is causing those other diseases; the precise nature of the link remains mostly mysterious.)
A 2013 study in the journal CardioRenal Medicine also found that patients with both chronic kidney disease and periodontitis were more likely to die of cardiovascular disease, a leading cause of death among those with kidney problems. The study was unable to find the reason how and why gum disease contributes to heart disease deaths, but the researchers recommended curbing periodontitis in patients suffering from kidney disease.
Those with diabetes are also at a higher risk of developing gum disease, and vice versa. A 2012 study in the journal Diabetologia suggests that there is evidence "supporting the existence of a two-way relationship between diabetes and periodonditis, with diabetes increasing the risk for periodonditis and periodontal inflammation negatively affecting glycemic control."
Diabetes is manageable with the right diet and the right medication, and those suffering from it often have the same life expectancy as those without. But the same Diabetologia study found that those with diabetes and gum disease were three times more likely to die from heart and kidney diseases than diabetic people without gum disease.
So the next time you find yourself standing in front of your bathroom sink, take a couple minutes to floss. Your older self will thank you.
