Okay, so what can you almost be guaranteed your dentist is going to ask you at each visit, “So, have you been flossing?” But a couple of years ago, the Associated Press (AP) caused a bit of a stir when they issued a report calling into question the medical benefits of flossing! Seriously? When we heard that news, obviously we knew it was something we had to get to the bottom of. So let’s start digging.
What’s All the Floss Fuss About?
So, what exactly did the AP report say? Basically, it pointed out that results from flossing research over the past decade were inconclusive. Basing their report on 25 rigorous studies, they found that the evidence for flossing was “weak, very unreliable,” carries “a moderate to large potential for bias” or was of a “very low quality.” According to the AP, one study stated that “the majority of available studies fail to demonstrate that flossing is generally effective in plaque removal” while another cites “inconsistent/weak evidence.”
Flossing has been recommended by the federal government since 1979. Yet, after the AP contacted the departments of Health and Human Services and Agriculture, asking them to provide scientific evidence, flossing was removed from the latest dietary guidelines.
Sounds convincing, right? Well, don’t throw the floss away just yet! There’s one very big problem with the conclusion drawn by the AP report: they don’t present any evidence that flossing doesn’t work. The crux of the report rests on the fact that there’s a lack of documented pro-flossing research, but that doesn’t mean that the medical benefits of flossing don’t exist, it’s just that it can be difficult to substantiate them.
So, why haven’t there been any rigorous studies supporting flossing in the past decade? One of the main reasons is that the efficacy of flossing is down to technique. That’s to say it’s not really about if you floss, but how you floss. Many people floss using a sawing motion, rather than going up and down along the sides of their teeth, as is the recommended method. So, unless we were sure that all the research participants had received years of professional flossing --and I think we can agree that’s pretty unrealistic -- it’s really hard to say how effective flossing is.
In addition, a substantive, long-term trial would require the use of two groups: a “control” group (of those who don’t floss) and a “study” group (of those who do floss). A study that required people to neglect their oral hygiene is unlikely to be approved on ethical grounds. When you take this into consideration, it’s not unsurprising that studies pointing to the beneficial effects of flossing are conducted over the short-term or show clinically small patterns of results.
What’s the Verdict: Floss or Forget It?
Despite all this, we still recommend including flossing in your oral healthcare regime. For what it’s worth, so does the federal government and the ADA. Incidentally, the reason for the removal of flossing from the government’s dietary guidelines was because it was identified as a supporting recommendation, with the primary emphasis being on nutrition. Regardless of the lack of strong, documented evidence, it’s still extremely important to clean the space under your gum line and between your teeth. If left unchecked, the plaque and debris between your teeth can lead to cavities or gum disease. Flossing twice a day is still the best way to combat that...and to make you look like a superstar at your next dentist appointment.
What are your thoughts on the great flossing debate? Do you floss, and if so, does your mouth feel noticeably cleaner? Let us know in the comments below!