Flossing: Yay or Nay?

Patients

by Brent Hearn • 

Flossing probably isn’t on your personal top-ten list of favorite discussion topics. (If it is, you’re either a dental health professional or you really need a hobby.) But throw in a pinch of controversy and nearly anything can get more exciting, right? And as it turns out, people who conduct and talk about research for a living—scientists and journalists and whatnot—can get really touchy about flossing.

People have a lot of questions about flossing, and there are a lot of conflicting answers. And if the people whose job it is to research the topic can’t get on the same page, we’re certainly not going to pretend to be experts. What we can do is offer information, promote discussion, and maybe even teach you a thing or two!

Q: Should I really even be flossing? Because I read somewhere that it doesn’t actually do any good.

A: Yes, you should probably still be flossing. (Or at least doing something that accomplishes the same tasks, but we’ll get to that later.) 

True, there has been some controversy about the effectiveness of flossing, much of which came about because of the quality of the body of research. Some studies have conflicts of interest (they’re conducted by companies that manufacture floss), others haven’t the duration required to measure long-term effects, and so on.

That said, there’s a big difference between saying there’s not enough research to prove flossing is effective and saying flossing has been proven to be ineffective. (Scientific rigor is important, and so is wording.)

There are a number of possible benefits of cleaning between your teeth with floss or some other means (again, we’ll get there later), including plaque reduction, gingivitis prevention, and bad breath. Just because flossing hasn’t been proven to be effective (or as effective as previously thought) in one area certainly doesn’t mean it’s ineffective in all areas, so let’s be careful not to throw the baby out with the bathwater. 

Q: But if the evidence is conflicting, why should I continue to floss?

A: Plenty of experts, including the American Dental Association (and likely your own dentist), recommend it. From the ADA’s website: “Interdental cleaning helps remove debris and interproximal dental plaque, the plaque that collects between two teeth; dental floss and other interdental cleaners help clean these hard-to-reach tooth surfaces and reduce the likelihood of gum disease and tooth decay.”

Q: I’ve read that flossing can improve other aspects of your health than just your teeth and gums. Is that true?

A: It’s possible that cleaning between your teeth can have positive ramifications for not just your dental health and hygiene, but for your health overall—and possibly your longevity as well.

For instance: inflamed gums can mean a bacterial infection in your mouth. The bacteria can find their way into your bloodstream, causing plaques and inflammation. Both can contribute to heart disease. Since flossing can reduce gum inflammation, doing so regularly could provide a life-extending bonus outside a set of healthy chompers.

Q: I really, really hate flossing. Are there other methods I can use to clean between my teeth?

A: Yes, there are others, including interdental brushes (IDBs), woodsticks, and oral irrigators. In fact, some of them may be more effective than flossing. Take this recommendation from a study entitled Efficacy of Inter-Dental Mechanical Plaque Control in Managing Gingivitis – a Meta-Review: “Evidence suggests that inter-dental cleaning with IDB’s is the most effective method for interproximal plaque removal. IDB’s were consistently associated with higher levels of plaque removal when compared to flossing and the use of wood sticks.”

Q: You’re probably going to close out this article with some kind of pat advice about “consulting with your dentist” or something, aren’t you?

A: Well, we certainly wouldn’t want to disappoint anyone, now would we? When it comes to flossing—or any other topic related to your oral healthcare—talk to your dentist. 

Sources:

https://www.forbes.com/sites/emilywillingham/2016/08/03/5-good-reasons-to-keep-flossing/

https://www.vox.com/2016/8/2/12352226/dental-floss-even-work

https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/floss

https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12363

https://www.verywellhealth.com/simple-steps-to-increase-your-life-expectancy-2223907

https://newsinhealth.nih.gov/2016/11/dont-toss-floss