A System for Positive Reinforcement of Good Flossing Habits for Children


Dr. Christopher Hekimian, Dr. Sc. SE Email Author
Dr. Benjamin Manesh, D.D.S.


We have been engaged in research and development of a system for flossing regimen verification that directly supports a means of positive reinforcement that we feel will be effective in establishing good flossing habits in children. The system has been developed consistent with the observation that children are more likely to engage in regular flossing if they are provided with an incentive to do so. The use of a positive incentive as a tool to promote flossing habits is very important, because to children, the reward for flossing seems extremely remote. It is doubtful that children give much consideration at all to whether or not they might get gum disease in the distant future.

Our system involves a means of packaging dental floss in such a way that the faithfulness with which the flossing regimen is adhered to can be verified by a parent accurately, so as to provide a sound basis for either granting or withholding the incentive to/from the child. Our system has been designed in such a way that daily flossing will likely be perceived as a game or contest, while the child is building good dental hygiene habits. However, it is a game or contest that the child can always win, if he or she flosses everyday. Conversely, if too many days are missed or if the child attempts to cheat the system, using our method, the fact becomes evident to the parent, and the child would have to try harder next time, in order to win a prize.


Many developments in dental floss have come about in an attempt to make flossing more appealing to children and adults. Flavored flosses and multi-colored flosses, are all pretty dry results of attempts to inspire children to floss regularly. Parents have always been able to offer incentives to their children to brush and floss. But until now, the parent never really had the means to determine whether the child was actually compliant. Just about everything seems more important to a child than good dental habits so unless the parent is going to stand over their child's shoulder every morning there is a good chance that there are regimen lapses either in flossing or brushing that the parent is not aware of. As a personal observation, before test patient number one was introduced to our system for floss regimen verification and reward, 50 yards of dental floss lasted a remarkably long time. Several years, in fact. Another approach to enforce flossing regimen compliance is the dental chair lecture. Our experience has shown that if sound flossing habits aren't instilled in children at the home, brow beating them while they are in the chair once every six months is not likely make much of a difference. Another approach is to attempt to frighten children into compliance using pathological photos. One must wonder whether dental office visits might tend to be more appealing if they were lighter on the lectures and the threatening photographs and could somehow be more positive.


Our system, which we call "Rainbow Fun Flossing" is based upon a packaging technique which we feel is somewhat clever. First, to make flossing easier, a mark is placed along the floss length every 18 inches so that a uniform length can be retrieved with each use. That this is an important aspect to our system will soon be evident. At a location within the roll of dental floss there is one 18 inch segment of multicolored "rainbow floss". The location of the rainbow segment with the roll is unknown by the parent or child until the parent removes a special label affixed to the floss box at the start of a rainbow flossing regimen. The label is imprinted with the number of 18 inch segments along the roll of floss where the rainbow colored segment is located. The parent then retains the label in his or her wallet or anywhere else where the child will not have access to it. We have also affixed a writeable label to the back of the box which allows the day on which the regimen started can be clearly marked. So, basically the parent provides the incentive to the child in the following manner, " Suzie, if you floss everyday then we will take you to whatever movie you want. All you have to do is floss everyday and when you get to the rainbow floss, bring it straight to me!."
The flossing regimen verification system is now in place. If Suzie flosses once everyday she will encounter the rainbow floss after exactly that many flosses that corresponds with the label that is being held by her parent. Assuming a one flossing a day regimen, if the rainbow floss segment was number 32, counting back 32 days from the day on which Suzie produces the rainbow colored segment should yield the start of the regimen. We have designed some regimen count-back systems as part of our packaging system for Rainbow Floss but a calendar works fine. Now, should the parent count back 40 days to the start of the flossing regimen, it would be quite clear that Suzie had missed exactly 8 days of flossing. If Suzie were to produce the rainbow segment after 18 days, then it would appear that either "someone" had been pulling segment after segment of rainbow floss out of the box, or that Suzie has been flossing more than once each day. We are not aware of many cases of pediatric over-flossing so we would be inclined refresh Suzie on the rules to our Rainbow Floss game.


We have developed a system for floss regimen verification in support of positive reinforcement of good flossing habits in children. We believe that the system has great promise and that it should be relatively easy to get parents to understand how the system works and to agree to adopt the system for the benefit of their children. We have been issued a patent on the system, itself as well as the packaging technique that supports the regimen verification function of the system. We would be interested in entertaining the thoughts and questions of any parties interested in the new technique, especially those inquiring into the potential for commercialization of the system. We would be happy to collaborate or support with materials, any parties interested in conducting trials or a pilot study involving the new system.

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First Published June 2004