What better time for wistful thoughts about medical science than those daily sessions at the bathroom mirror with lips curled into a sneer and fingers looped in dental floss?

The sneer is apt, considering the sorry state of this technology. It lags behind even the "chewing sticks" that people in developing countries have used for centuries to clean their teeth.There's plenty more to ponder and scowl at as you pull the floss gently between each tooth, and sweep it under the gum margin to remove bacterial plaque. If this routine doesn't sound familiar, beware. Those who don't floss risk losing their teeth.

Dental plaque is the sticky film of food debris, and microbes and their waste products, that causes periodontal disease. The condition damages the gums and other tissues that hold teeth firmly in the mouth.

Suppose gum disease really is the most serious dental health threat for American adults: the leading cause of tooth loss and the main reason why 30 million Americans have lost all their natural teeth.

Suppose that gum disease really does occur in three out of every four people. Then why on earth are we left to control it with this high-technology, 21st century, absolutely visionary approach of pulling a piece of string through our teeth?

If ever a disease cried out for innovations in prevention, it is this grim reaper of our teeth. There have been advances in at-home prevention of periodontal disease. These include anti-plaque mouth rinses; a new generation of toothbrushes designed to better clean the teeth; anti-plaque toothpastes, including some incorporating fluoride, hydrogen peroxide and baking soda; and electric toothbrushes designed to remove plaque.

But dental floss remains the bulwark of plaque control, and there is abundant evidence that it is inadequate. People are supposed to floss at least once a day to remove plaque left behind by brushing. Yet studies show that many people don't floss regularly.

The Academy of General Dentistry in Chicago reports that Americans buy only about 59,000 miles of dental floss each year. That's about 12 inches per person, barely enough for each person to floss once.

People apparently believe that using conventional floss isn't worth the bother. Medicated dental floss is a dream.

Dental floss removes bacterial plaque by mechanical action, using the same principle as "chewing sticks" that people in India and other countries have used since ancient times. Pluck a stick from a tree like the neem, gnaw the end into a mass of mop-like fibers, and scrub away.

But chewing sticks are high-tech compared to floss. Sticks from the neem tree contain natural antibacterial compounds believed responsible for the good oral health found in developing countries.

A revolution has occurred in developing new drug delivery systems. These include transdermal patches, microencapsulation, timed-release systems and other innovative ways of administering medication. Can we really lack the ability to coat dental floss with medicines that kill plaque bacteria, enzymes that dissolve plaque film or microcapsules that adhere to the teeth and continuously medicate the gums.

One's upper lip and cheek curl into a surly scowl as floss-wrapped fingers pass the canines, and dawdle over the first and second premolars. Lo, even the eyebrow contorts into a frown when floss approaches those remote first and second molars, and you contemplate toothpaste.

The latest in high-tech is fluoride toothpaste fortified with the periodontal disease fighting duo of hydrogen peroxide and baking soda. Readers tell me their grandparents used peroxide and soda half a century ago. Where is gum disease's equivalent of fluoride? When do we get a genuinely new toothpaste ingredient that will do for gum disease what fluoride has done for tooth decay - push it toward extinction?