title: Periodontal bone loss associated with an improper flossing technique: a case report.
abstract: OBJECTIVE
  This article documents a case in which soft tissue and bone damage was associated with a long-standing habit of improper flossing.
  
  
  METHODS
  A 33-year-old patient with excellent oral hygiene presented with gingival clefting and an unusual pattern of moderate angular bone loss at several sites. Previous radiographs suggested that some bony lesions had been present for more than 13 years. Examination revealed no evidence that the osseous defects were related to chronic periodontitis or occlusal trauma. The focus of treatment for these chronic injuries was teaching the patient an atraumatic flossing technique.
  
  
  CONCLUSIONS
  As the lesions had gone undiagnosed for many years, this case underscores the need to look for clinical signs of floss-induced damage during periodic examinations.
authors.affiliation: Section of Periodontology, College of Dentistry, The Ohio State University Health Sciences Center, Columbus, OH, USA. walters.2@osu.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Walters
authors.forename: E I
authors.initials: EI
authors.lastname: Chang
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology*; D003742:Dental Devices, Home Care / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000293:injuries*; D005889:Gingival Recession / Q000209:etiology; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D009910:Oral Hygiene / Q000009:adverse effects; D010353:Patient Education as Topic