Written by: Dr. Chang, August 2016
Should I stop flossing?
Last week, the Associated Press dropped the news that flossing just doesn't work. They article stated:
“It's one of the most universal recommendations in all of public health: Floss daily to prevent gum disease and cavities.
Except there's little proof that flossing works.”
The Surgeon General's recommendation for flossing was removed earlier this year. While recently the AP had requested evidence to support their previous recommendation, the federal government could not provide enough evidence to demonstrate the efficacy. If you look at the research base, they are correct. The studies on flossing are limited and not overly convincing. As a result, the government had to remove the recommendation to the public in order to be consistent with their standards.
While this may bring some relief to millions of dental patients around the world who receive that constant reminder to floss from their dentist and hygienist, just hold on to that floss before you throw it away.
So while the effectiveness of flossing isn't statistically proven to prevent gum disease and tooth decay, it's also not disproven. In other words, it doesn't mean there's conclusive evidence that it doesn't help. More research is needed, but there isn't going to be a rush to flossing research. You would have to run a large, longitudinal, double blind epidemiological study. But this takes significant time and funding, let alone ensuring the participants are flossing correctly, even if they are.
So, the questions is...would I still floss in the absence of high-level evidence?
The main goals in oral hygiene management is to remove the biofilm of bacteria, what you commonly hear at the dentist's office as “plaque”. This plaque is responsible for tooth decay, gingivitis and periodontitis (disease of the gums and bone).
Toothbrushes remove plaque, but don't reach in between our teeth. Floss does. It disrupts the film of bacteria, and removes food debris. It keeps your teeth cleaner, it's low risk, and inexpensive to add to your hygiene regimen.
Try this tonight when you floss – smell it. What you are smelling is a mixed bag of bacteria and their by-products, and food decaying between your teeth!
If flossing has not been conclusively shown to reduce the risk of tooth decay and gum disease, it does at least reduce plaque, the main cause of these two dental conditions. So while the evidence is inconclusive, there is a good biologic plausibility for a benefit.
What do you think? Will you still floss? We would like to hear about it!