Everyone loves a pearly, white smile – it’s universally recognized as one of the most attractive features and it helps to make a good first impression. That said, straight teeth and a white smile do not necessarily denote the best oral health.

You can keep teeth looking nice by brushing regularly and using bleaching products like whitening toothpaste, strips, or even professional bleaching trays. However, your bright smile could be hiding a dirty secret if you forego flossing. Just because you can’t see the harm you’re doing doesn’t mean it’s not there, lurking below the surface of your gums and even inside your teeth.

If you fail to floss, you might get away with it for a little while, but eventually your dentist will be able to tell you haven’t been following directions for optimal oral health, and if you let it go too long, the side effects could become visible to everyone. You might think flossing isn’t necessary, but it is.

What happens if you don’t floss? What are the common signs and symptoms associated with skipping this essential part of your oral health regimen? Here’s what you need to know.

1. Plaque and Tartar Buildup

Let’s start with a little lesson on where plaque and tartar come from. When you eat, food particles can remain behind in your mouth afterward, sticking to every surface, from the hard enamel on your teeth to the soft tissue of your tongue, cheeks, and gums. These leftovers feed bacteria in your mouth.

The mingling of food, bacteria, and the waste bacteria produces creates a sticky substance called biofilm that clings to your teeth. Within about 24 hours, this will start to become plaque, and it will get harder to remove (which is why brushing, flossing, and rinsing daily are so important). Over time, the plaque will build up and begin to harden into calculus, more commonly known as tartar, and this will require the services of a dental professional to remove.

As you can see, a lack of flossing will start to show pretty quickly. You might get the plaque on the surfaces of teeth when you brush, but it can still build up between teeth and below the gum line when you fail to floss.

2. Bleeding Gums

This is the most telltale sign that you’re not flossing. Brushing your teeth removes the biofilm that builds up on exposed surfaces, but misses the part of your tooth that is below the gum line. When you floss, you not only get the spaces between teeth where food particles and bacteria linger, but also the areas below the gum line where bacteria can grow and fester, irritating your gums.

This, in turn, can lead to tenderness and swelling, and when you do floss, or even brush. It’s common for bleeding to follow. If your dentist notices swollen and bleeding gums during your visit for checkup and cleaning, it’s a good bet you haven’t been flossing, and dental professionals will know.

3. Gum Disease

When bacteria are allowed to linger below the gum line, they can start to irritate and infect surrounding soft tissue. This begins with minor swelling, bleeding, and tenderness, but over time it can turn into gingivitis, or inflammation of the gums that develops into serious gum disease. As plaque forms and hardens into tartar, it releases toxins that irritate gums. Flossing helps to eliminate this threat.

4. Tooth Decay

When plaque builds up below the gum line, it not only affects your soft tissue, but also your teeth. The waste products left by bacteria are acidic and they will attack the protective enamel on your teeth. When this happens, an infection can form inside the tooth, leading to issues like cavities, especially between the teeth and below the gum line. This is so easy to combat when you brush, floss, and rinse with mouthwash regularly.

5. Periodontitis

As dentists in Raleigh NC will surely tell you, things can go from bad to worse pretty quickly when you forego proper oral hygiene. If you brush regularly, issues may take longer to develop, but when you neglect the health of your gums by failing to floss, you will see worsening conditions over time.

Gingivitis and tooth decay can develop into periodontitis, or infection of the tissues surrounding teeth, including the gums, jawbone, and connective tissues that support teeth and keep them healthy and functioning properly. Periodontitis is not impossible to reverse, but it is difficult, and therefore best avoided. If you want to keep your pearly whites permanently affixed to your jaw, preventing periodontitis is wise, and a daily regimen of brushing, flossing, and rinsing is the first step.