Why is it so tough to remember to floss?

I rarely run into patients who can’t remember to brush their teeth twice a day, but even the most conscientious among us come to their hygiene appointment anxious and awaiting the hygienist’s lecture about flossing.

Flossing can be icky and awkward — no one likes feeling like they’re shoving their entire fist into their mouth. But the reason why we don’t make flossing a habit is a bit more complicated and has its roots in psychology.

During the early 1900s, right around World War I, dental hygiene was so bad, it was said to be a national security risk. Why? People weren’t brushing their teeth, of course, and the 1900s marks the period when Americans first began to consume sugary, ready-to-eat processed foods, such as crackers, breads, and potato chips.

America’s brushing habits were forever changed at this point by a toothpaste campaign that told people, “Just run your tongue across your teeth. You’ll feel a film — that’s what makes your teeth look ‘off color’ and invites decay. Why would you keep a dingy film on your teeth? Our toothpaste removes the film!”

As Charles Duhigg explains in his book, The Power of Habit, the success of this campaign was in its ability to create a craving in people, which is at the heart of all habits.

In order to make a habit, Duhigg asserts, you need the following:

  1. A simple and obvious cue
  2. A clearly defined reward

When people ran their tongue across their teeth as the campaign instructed, that became a simple and obvious cue for them to brush their teeth. The reward? Removing the “dingy film” on their teeth. The ad people had created a craving. If people forgot to brush, they missed that “tingling clean feeling.”

Now, back to flossing. The problem with flossing is there is no instant gratification, no clearly defined reward. People don’t think it’s working.

Unfortunately, our brains are not wired to develop habits that will do good things for our health 10 or 20 years later.

Flossing is going to prevent decay, keep your teeth and smile looking young as you age, prevent your teeth from falling out, prevent gum recession, expensive dental bills, and pain – so trick your brain into making it an effortless routine that you perform on autopilot.

Start with giving yourself a simple and obvious cue (you might decide to floss every night before bed) and a clearly defined reward, like a favorite flavor of floss. For children, a sticker for every day on a flossing calendar in the bathroom is a great way to cement the habit.

  • Create a cue. I tell my patients to take a blank Post-it and stick it on your mirror. That’s a cue. Don’t write things like “floss” on it — that sounds too authoritarian and disciplinary. Every time you see that Post-it, you’ll know deep down that means to floss. I did this to get into the habit myself.
  • Make it easy. Keep floss stashed everywhere. The samples of floss you get from the dentist are great for this. Keep one in your desk drawer at work, your gym bag, in the car, in your laptop bag, and your travel toiletry case. We might not think of flossing late at night before bed because we’re tired, but the thought (or craving) could hit you during the day.
  • Invest in a flossing stick, which is basically like the handle of a toothbrush, but with floss on the top. These are fantastic, I use one myself. They turn flossing into a one-handed operation and are awesome for multi-taskers — you can flip through your phone with one hand while flossing with the other.
  • Take the pressure off. Don’t do what the hygienist tells you, which is to floss every day. This can be too much of a jump and too much to expect right off the bat. It’s easy to get frustrated when trying to get in the habit of flossing, especially since so much coordination is involved with it.

    What I tell my patients is, floss once a week. What ends up happening is they floss once, and a few days later, begin to crave the feeling again. When you floss once, you get the sensation of the separation of the teeth, stimulation of the gums — it’s a distinct feeling, almost like a massage. Which is why you’ll crave it again. This can be a much better way to break into the habit of flossing daily.

You can think of flossing like kicking over an anthill each day. You can kick the anthill to destroy it, but each day, the ants come back and build a new one. Flossing one week before your appointment with the hygienist isn’t going to prevent gum disease, tooth decay, and gum recession — but keeping up with that “anthill” and flossing daily, will.