I admit it. I don't floss every day. I used to not floss at all, and gave typical excuses for this lapse - it hurt my gums, it hurt my fingers, it was inconvenient, and it took too long.

My dental hygienist kept bugging me about it though, so now I try to floss at least twice a week. Now that I've mastered the flossing technique, my gums don't bleed every time I brush my teeth, and the pockets between my teeth and gums have become a little smaller than they used to be.

Truthfully, I wasn't originally convinced that flossing was that important - after all, what's a little gum irritation going to do to me? However, there is evidence that gum disease and periodontitis could have effects beyond our mouths.

Most people have heard by now that periodontitis is associated with an increased risk of heart attack. This risk isn't nearly as high as with diabetes, smoking, hypertension, and high cholesterol. But it is probably at least as elevated as that linked to long-term use of Bextra^® and Vioxx^® (pain drugs that were removed from the market in large part because they were associated with a small increase in heart attack risk).

The evidence also suggests that periodontitis might contribute to pregnancy complications. Some studies show an increased risk of premature birth and low weight for babies born to others with periodontitis. Other studies did not find any such risk, so we don't yet know for sure if this is a true association.

There is a logical explanation for why heart attacks and pregnancy complications could be related to periodontal disease. Blood tests in people with periodontitis show increased levels of C-reactive protein (CRP), a substance that has gotten a lot of attention in recent years as a possible predictor of heart attack, stroke, cancer, and a variety of other serious health problems.

The common feature in all of these conditions is the presence of inflammation, which is actually all that an elevated CRP level tells us. We know that inflammation is a major factor in periodontitis, and that inflammation is also important in both heart disease and preterm births of low-weight babies.

What we don't know is whether the possible association between periodontitis and heart disease or pregnancy complications is because of a direct effect of the inflammation in the mouth or of some other as yet unknown problem present in all three conditions.

So the jury is still out on whether preventing or treating periodontitis does anything to reduce your risk of heart attack or improve your chances of delivering a healthy baby after a full-term pregnancy.

I don't know if regular flossing is really doing me any good outside of making my mouth healthier. But it definitely improves my chances of keeping my own teeth into old age. Now that I'm used to it, it doesn't hurt and doesn't really take that much extra time. And I just might live a few extra years as a result, meaning that my teeth have to last even longer!