Don’t take flossing advice from mainstream media
A few years ago, the news was abuzz with stories about the lack of scientific evidence to support the claim that daily flossing is beneficial. Here are a few of those headlines.
U.S. News and World Report “Health Buzz: Flossing Doesn’t Actually Work, Report Says” (1)
The Telegraph “Flossing teeth does little good, investigation finds as US removes recommendation from health advice” (2)
CBS News “A big problem with flossing” (3)
New York Times “Feeling Guilty About Not Flossing? Maybe There’s No Need.” (4)
So, what exactly triggered all these stories? In 2015, the federal government decided to remove their recommendation for daily flossing from their Dietary Guidelines. Why? Did science suddenly discover in 2015 that flossing had no health benefits? No.
Below is the technical reason why they removed it.
The government rules say that the Dietary Guidelines can only include recommendations that are backed up by “high level” scientific evidence. What is considered “high level” scientific evidence?
The best example of “high level” scientific evidence is what they call a Randomized Controlled Trial (RCT). One group (randomly selected) is experimental and one group (randomly selected) is a control. Group A flosses. Group B doesn’t floss. After many years, you study the results. Well…here’s the problem. We don’t have any RCT’s proving flossing works. Why not?
Two main reasons why we don’t have RCT’s that prove flossing works
Ethics
In most cases, gum disease and cavities develop over many years. Researchers cannot ask a group of people to not floss for that many years. That is unethical and will not fly. In other words, it’s not even allowed to happen.
Are they actually flossing?
Even if we could violate that ethical standard, we would still have a problem. For example:
- How do we know if the flossing group is actually flossing?
- How do we know if the flossing group is flossing correctly?
- How do we know if the non-flossing group is not flossing?
To verify those things we would need dental professionals to follow these people 24/7 for 10-20 years. That is not realistic at all.
We don’t have RCT’s to prove flossing works because technically, we can’t. But we also don’t have RCT’s proving that flossing doesn’t work. Here’s what we do have. We have scientific evidence (at a lower level from RCT’s) that show flossing is beneficial. For example:
- At least one 1977 study (before modern ethical limitations) used dental professionals to floss kids’ teeth in a school environment. The results showed a significant reduction in dental cavities between teeth (a.k.a. interproximal dental caries). (5)
- Millions of dental professionals around the world see the difference flossing makes with their patients who embrace it as a daily habit. This is anecdotal evidence, but it still has value.
Right after the flossing recommendation was removed, the
The U.S. Department of Health and Human Services emphasized, “flossing is an important oral hygiene practice”.
The American Dental Association (ADA) said, “Although some have questioned the benefits of cleaning between your teeth, using an interdental cleaner (like floss) is an essential part of taking care of your teeth and gums.”
Flossing works and continues to be strongly recommended by the dental profession.
If you have any questions about flossing, please ask your dentist or dental hygienist, not the New York Times.
If you are currently looking for a dentist in the Taunton, MA area, Dr. Mark Turner and his dental hygienists Angela, Amanda, Kristina and Stephanie would love to see you.
They’ll tell you all about floss and the many floss alternatives. They care about your oral health, not click bait headlines.
Links
1. “Health Buzz: Flossing Doesn’t Actually Work, Report Says”, https://health.usnews.com/wellness/articles/2016-08-02/flossing-doesnt-actually-work-investigation-concludes
2. “Flossing teeth does little good, investigation finds as US removes recommendation from health advice”, https://www.telegraph.co.uk/science/2016/08/02/flossing-teeth-does-little-good-and-us-removes-it-from-health-ad/
3. “A big problem with flossing”
4. “Feeling Guilty About Not Flossing? Maybe There’s No Need.”, https://www.nytimes.com/2016/08/03/health/flossing-teeth-cavities.html
5. “Effect of interdental flossing on the incidence of proximal caries in children”, https://pubmed.ncbi.nlm.nih.gov/268338/