Let's Talk About Flossing
Surely you've seen the headlines - "Flossing is Nonsense and My Laziness is Vindicated" or "Flossing: Government's Latest Piece of Bad Advice". All this press about flossing stems from an article published this month by the Associated Press (Read it here). Their report points out the weak evidentiary basis for floss as a method of reducing plaque and tooth decay. The American Dental Association responded saying: Trust us, flossing helps.
In reality, the AP article is less about floss and more about evidence-based medicine. They are correct in that the published and proven evidence for the benefits of floss is poor. One reason for this is that floss has been around since the 19th-century! Recommendations for flossing are based on pretty obvious assumptions: it removes plaque from in between teeth and because plaque leads to gum disease and decay, flossing will improve these conditions. But because our medical standards have risen so greatly in the last centuries, assumptions are not enough - and understandably so.
Anecdotal evidence and long-standing traditions have been replaced with evidence-based medicine. This approach is dependent on well-designed, controlled studies. Thus far, nobody has tackled a flossing study with the academic rigor we now expect. Why? We can only speculate. Studies like this are expensive and there is no fame or monetary reward to be found in proving out flossing. Flossing is cheap, easy to adopt and no-risk. This leaves us with anecdotes and weak evidence. Two of our leading dental associations — the American Dental Association and the American Academy of Periodontology — cited other studies as proof, but most of these studies used outdated methods or had relatively small sample size.
Despite our agreement regarding poor studies and evidence around flossing, this does NOT mean it has been proven ineffective either. Each of your teeth have six surfaces and brushing can only clean four of them. You simply need a method for cleaning in between your teeth to properly remove all plaque causing substances that are proven to cause decay.
We always hoped more people would talk about flossing - but not like this! At the very least, we hope this exposure will inspire researchers to conduct better studies and counteract these claims made by the AP. Oh, and by the way - even the author of the article admits he still flosses. If you have any questions, feel free to contact us directly or leave a comment. We'd love to hear from you.
For Further Reading
This 2006 study titled, “Dental Flossing and Interproximal Caries: a System Review,” recruited 808 children age 4-13 and split them into three test segments: kids who were professionally flossed 5 days/week; kids who were professionally flossed once every 3 months; and kids who reported self-flossing at home. The research lasts 18 months and unsurprisingly, the participants who were professionally flossed 5 days/week saw a 40% decrease in the risk of cavities.