To floss or not to floss? That is the (toothy) question.
Earlier this month, the government claimed there is no proof flossing prevents tooth decay or gingivitis. I knew something was rotten in Denmark since I can attest to the practice after I had excruciatingly painful gum surgery nearly 15 years ago. After doing some digging, I found the devil really is in the details or lack of details when it comes to flossing research.
It seems like common sense to floss after eating. Rotting food particles left behind aren’t going to do your teeth and gums any favors. Maybe that’s why there has been so little research when it comes to flossing. Paired with the fact in clinical trials the gold standard is a double-blinded placebo; in layman’s terms the subjects nor the researchers know who is taking the real medication or who is taking a fake.
You may see where this is going. The double-blinded placebo works fine with things like medication, but when it comes to flossing there is no placebo. You either floss or you don’t.
There has never been an extensive, rigorous study devoted to flossing for several reasons. The methodology in tracking whether or not someone flosses doesn’t really exist. There’s no good way to track whether or not subjects floss or not. On top of that, dentists aren’t going discourage flossing for ethical reasons.
Many dentists have complained about the technique researchers used during trials. I still remember my periodontist saying many people use floss incorrectly, moving it in a sawing motion instead of up and down the sides of the teeth. Not to mention how floss toughens up the gums when used continently. My periodontist tells me he knows when patients open their mouths which ones have been flossing and which ones haven’t been, because their gums are healthier.
In a classic tail wagging the dog situation, the Associated Press investigation may have sparked the government to take a closer look at shoddy research, prompting them to release the “no proof” statement. I was scared straight in my mid-twenties after having gum disease literally cut out of my mouth. Since then, I have flossed religiously and never had a cavity. Furthermore, I hadn’t visited the dentist in a couple of years but when I showed up recently for a cleaning, again, no cavities. Flossing has literally saved me thousands of dollars and spared me the horrific experience of more gum surgery.
The decision to drop flossing from its list of federal recommended guidelines came not because there was solid evidence, but that it was ineffective. It came because there was a lack of scientific evidence due to the ethical and practical considerations inherent in conducting a broad and long-term study on the practice, that flossing effectively prevents tooth decay and gingivitis.
It’s bordering on unethical to release a statement without adding more empirical research is warranted on the practice before a conclusive decision can be made. Just ask those who floss regularly how it’s improved their lives.