Figure 1: Cocolab’s Cocofloss allows for excellent grabbing and cleaning of interproximal crown cement. Postcementation radiographs have been, on average, freer of remaining cement.

Dental floss, reimagined

April 11, 2024
Dr. Neville Hatfield has discovered a new dental floss that’s a holistic, natural, and fun alternative for patients. He says the floss offers some serious clinical benefits for dentists too.

When is the last time you thought about the floss you use? What about the floss you recommend to your patients? Do you even recommend floss anymore with the continued development of water flossers?

It’s not every day that a company comes along and changes a stalwart dental product into something more capable and, in my opinion, more effective. Along the way I discovered a dentist-founded company that has helped reimagine dental floss, and they gave me a variety of their products to try.

The Cocofloss brand (soon to be renamed Cocolab in Q3/Q4 of 2024) came into existence in 2015 when founders Dr. Chrystle Cu and her sister Cat became determined to create a floss that would be exciting enough for patients to use, but also more effective than current floss options. What they came up with is not only a product that I personally use, but also one I happily recommend to my patients. To top it off, I even found that clinically I prefer to use Cocolab’s Cocofloss in a variety of applications in my day-to-day general dentistry practice.

What makes Cocolab products unique?

To answer that question, I’ll approach it with two mindsets.

From the patient’s perspective:

The open market is continuing to expand into healthier, less chemically “scary” components and ingredients. We’ve all seen the increasing rise of products that stylize themselves as cruelty-free, vegan, and paraben-free. That is because consumers are asking for more options that fit that bill.

As a company, Cocolab has committed itself to these ideals, and all their products hold to the promise of a more holistic and natural alternative. This is great for patients who are more conscious about the products they buy. Even the wariest of my patients have loved Cocolab and happily switched over to their floss—and more recently, their toothpaste.

Additionally, Cocolab has done a great job in making flossing fun. It’s a bit of an oxymoron in the world of dentistry, but Cocolab has achieved this by creating flavors and scents of floss beyond the standard mint. With their typical flavors such as Pure Strawberries, Cara Cara Orange, Delicious Mint, and Fresh Coconut, it’s easy to convince kids—and even some adults—that flossing is something to look forward to. I've even had patients comment to me on how they get way more plaque and food out from between their teeth than they did with other types of floss. And I see those results when I complete my recall exams.

From the dentist’s perspective:

Why would you bother switching from a floss you already use every day in your clinical practice? I’m telling you that you should consider switching because of how Cocofloss is constructed. Made of hundreds of interwoven fibers, Cocofloss is stronger and more textured than most other dental flosses. Although it is slightly thicker than standard waxed floss, the fibers that are already performing well in the removal and cleansing of plaque biofilm also can grab leftover cement in the interproximal area after cementation of restorations (figure 1). Cocofloss also has their “plush” version to pull out excess cement, which I find incredibly helpful when cementing bridges or crowns with large interproximal spaces.

The interwoven design helps check for overhangs in restorations. I know I have some cleanup to do when I notice some of the floss fibers snagging on restorative overhangs (figure 2). By utilizing Cocofloss as my standard clinical floss, I’ve noticed a substantial decrease in the frequency of composite overhangs on my post-op and recall radiographs. It sounds silly, but their Mega Spool dispenser for my operatory is so satisfying to use. It’s easy to dispense and can be done one-handed because its adhesive base eliminates the fear of the dispenser moving from its spot.

Cocolab continues its innovation in dental hygiene products with its newest product, Cocoshine. Cocoshine is a wonderful fluoride-free and nano-hydroxyapatite-based toothpaste that is my go-to recommendation for patients seeking alternatives. Cocoshine has made hydroxyapatite toothpaste (which is very common in countries like Japan) more accessible for my holistic patients, while still performing the necessary anticariogenic effects of standard toothpastes.

Likewise, the company’s toothbrush (the Cocobrush) is a great recommendation for patients who need super-soft bristles or those who have a thin tissue phenotype that’s susceptible to recession. The bristles have a staggered design with longer bristles for subgingival and interproximal biofilm removal, and shorter bristles for polishing and smooth-surface biofilm removal.

Cocolab as a brand and line of products has changed the way I perform clinical dentistry. Their products allow me to be comfortable in my recommendations to patients and have even influenced me to change my at-home dental floss preference. The products are well made and follow the company’s ideals of sustainable, holistic dental products. Order a sample pack to experience the benefits for yourself. 

Editor's note: This article appeared in the April 2024 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.

Neville T. Hatfield, DMD, graduated magna cum laude from the Boston University School of Dentistry. He completed a general practice residency at the Manhattan Veteran Affairs Hospital, where he provided interspecialty comprehensive prosthetic and surgical treatment to medically complex patients. When he is not treating patients in northern New Jersey, he enjoys lecturing about dental materials and products.

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