Flossing clefts. Clinical and histologic observations.
Clinical and histologic observations of 14 marginal tissue clefts associated with improper floss manipulation are presented. Newly acquired lesions were characteristically inflamed, ulcerated and symptomatic while clefts of chronic duration were asymptomatic and un-noticed by the patient. Cleft sites exhibiting varying degrees of epithelialization generally presented apical bifurcations suggesting reinjury by the patient during lateral positional shifts of the floss. The terminology "flossing cleft" is suggested by the authors to describe linear or V-shaped interdental marginal tissue deformities that result from dental floss-induced injury. While these clefts may serve as a potential source of bacteremia during vigorous flossing and associated oral tissue manipulation, in no instances were they determined to constitute a morphologic impediment to effective plaque control efforts.