Time to Toss Your Floss?
By Krista Elliott
It happens to most of us when we go to the dentist.
"Have you been flossing regularly?" the hygeinist asks, as we squirm in our seats and mutter that we try to, but well ...
Daily flossing is a healthcare habit that many of us just haven't been able to turn into a regular one. And yet, we know that it's something that we really MUST do regularly for the sake of our oral health.
Or is it?
Is Flossing a Fraud?
In the 2015 Dietary Guidelines for Americans, flossing was dropped from the list of recommended ways to prevent cavities. When pressed, the U.S. government indicated that the guidelines had to be based on scientific evidence ... and that evidence supporting the effectiveness of flossing was lacking.
The Associated Press followed up by looking at recent studies on the effectiveness of brushing and flossing versus brushing alone, and found that there was only very weak evidence for flossing, and that the evidence carried "a moderate to large potential for bias."
So, that's great news, right? Lax flossers everywhere cheered the news, grateful that they no longer had to feel guilty about the dusty, disused spools of floss lying neglected in the back corner of their medicine cabinets.
As it turns out, though, the celebration may have been premature.
Part of the difficulty in obtaining strong evidence lies in getting a rigorous and iron-clad study done in the first place. The Cochrane Library, which analyzes medical studies, found that the studies themselves were severely lacking, with weak controls, unreliable self-assessment by subjects, and short study periods. As well, it appears that very few of the studies factored in whether the subjects were actually flossing correctly, with an up-and-down motion (as opposed to just sawing back and forth merrily).
With light being shone on the studies themselves, the question began to be asked: Was the evidence for flossing weak because flossing isn't beneficial ... or because the studies were shoddy?
So What's the Verdict?
The American Academy of Peridontology falls squarely into the latter school of thought, pointing out that weak evidence, instead of being proof of flossing's inefficacy, is actually more indicative of a lack of well-controlled, rigorous study. Dr. Wyne Aldredge, President of the AAP, states "Gum disease is typically caused when prolonged exposure to bacteria in dental plaque causes an inflammatory reaction. Flossing is an effective and useful way to remove the plaque, especially in between the teeth or under the gum line -- places where a toothbrush cannot reach."
The thing with flossing is that it may be a pain, but it's not a high-risk activity. You may have little to gain by doing it, but you definitely have nothing to lose. And if this recent controversy results in more stringent studies, we may yet wind up with solid evidence of flossing's benefits. So in the meantime, might as well haul out that floss -- who knows what tomorrow's scientific news may bring?