Lack of Evidence that Flossing is beneficial

[mama2one]

I found it quite the eye-opener. As someone who doesn't like going to the dentist anyway, I found it almost a relief, in an odd kind of way.

agree, they're all different

had a dentist who told me my how good my teeth were every time I saw him...then he retired

went to his replacement
all of a sudden, everything was wrong with my teeth!
this dentist even questioned if I was flossing
I said yes but it was like he didn't believe me cause he asked me about 3X

 

[FireDragon76]

Well, that didn't take as long as I thought it would; here’s the aforementioned article:

The Truth About Dentistry, by Ferris Jabr


-​

I wish it wasn't behind a paywall, but I got the gist by reading some responses online.

The lack of evidence-based approaches in dentistry is something that occurred to me years ago. It seems all too often they are too taken in with corporate woo as their main source of continuing education on patient care. A case in point: they always give away the most crappy, gimmicky toothbrushes as freebies, even though there are much better brands- if they really cared.

 

[public hermit]

Science says flossing doesn't work. You're welcome.

I recently found out there's a lack of scientific evidence that flossing is beneficial. I know it's an older story but I just thought of sharing it because it didn't seem to get alot of coverage years ago. An AP investigation revealed that there was a lack of scientific evidence behind the 2010 US dietary guidelines that Americans floss every day, so in 2015, mention of flossing was dropped in subsequent guidelines. US dietary guidelines are required by law to be evidence-based.

Personally, I have never gotten much use out of flossing, with little obvious benefit for so much time spent, so I'm not surprised by the Associated Press's lack of finding evidence of flossing's efficacy. Newer electric toothbrushes that use sonic vibrations or pulse oscillations produce hydrodynamic effects that will remove plaque up to 4mm away from the brush, effectively cleaning deeper into tooth surfaces that may be difficult to reach. When I floss after brushing, I don't notice much of anything being removed in the process, as a result.

I have also heard that in other countries, such as India, it's very difficult to get dental floss, being unfamiliar to most people. It mostly seems to be more common in the English-speaking world, and it's not very popular even then.

My flossing habit is come and go, but I always feel better when I do. Hmm, maybe that's just Protestant guilt. I use a toothpick regular, which is probably sufficient. I can imagine the Codman Shurtleff Company creating a need when they came up with it.

 

[Rajni]

I wish it wasn't behind a paywall, but I got the gist by reading some responses online.

Here's Google's cached version, which hopefully eliminates the paywall feature:

https://webcache.googleusercontent....cd=3&hl=en&ct=clnk&gl=us&client=firefox-b-1-d


-

 

[FireDragon76]

Here's some examples of good toothbrushes:

https://www.amazon.com/Dr-Collins-Perio-Toothbrush-colors/dp/B0036ZA40W/ref=sr_1_2?crid=3QHFEL0GPHT6O&keywords=perio+toothbrush&qid=1642685539&rdc=1&sprefix=perio+toothbrush,aps,96&sr=8-2

https://www.amazon.com/Nimbus®-Microfine®-Toothbrush-REGULAR-Colors/dp/B005LB75NI/ref=sr_1_2?crid=2B4YCMQBW0RBM&keywords=nimbus+toothbrush&qid=1642685617&sprefix=nimbus+toothbrush,aps,85&sr=8-2

They have fine, soft tips and produce alot less gum irritation. They clean just as effectively or better than any of the bigger brands.

I have an Oral B electric toothbrush and it's one of the few brands that offers reasonably soft tufts among electric toothbrushes at a reasonable price (mine is battery powered, not rechargeable, as I don't have a convenient socket in my bathroom), but it's still more aggressive than any of the above aformentioned toothbrushes. Most electric toothbrushes are marketed towards folks that regularly commit genocide on their gums and enamel in the name of "whiter teeth".

 

[Kettriken]

Here's Google's cached version, which hopefully eliminates the paywall feature:

https://webcache.googleusercontent....cd=3&hl=en&ct=clnk&gl=us&client=firefox-b-1-d


-

I started to read the article but stopped after too much flashing back to my old dentist. When I first started there I would see others in the waiting room. By the end they could see me whenever, and I almost never saw anyone else there. That should have been enough to send me packing.

After a painful half year, and visits to two specialists, I went to a different dentist that came highly recommended. I still needed two teeth out, but thankfully they were back ones. My dad literally cheered when I switched to the one he and my mom go to. It's out of network but worth the small extra charge for quality healthcare. I haven't had a major problem since.

 

[FireDragon76]

An article by Waterpik discussing various alternatives to flossing:

https://www.waterpik.ca/en/oral-hea...al-Cleaning-waterpik-continuing-education.pdf

I think it's informative how it breaks down the steps involved in correctly flossing. It's alot more complicated than brushing teeth, and requires alot of manual dexterity that's unique to flossing.

An example of proper flossing, along with instruction/education. The dental hygenist makes it look easier than it is:

Public health guidelines need to reflect than not everybody has the dexterity or inclination to floss properly, and that there are many alternatives.

 

[FireDragon76]

I went to the dentist today, which is always an unpleasant experience (my teeth are always sensitive afterwards), just to get a long-overdue checkup (I haven't been in over a decade).

The dentist was baffled that I had two brown "stains" that on further inspection, turned out to be remineralized cavities. She acted like she doesn't often see that sort of thing. She did say I had one small cavity that I should probably have filled. I told her I would wait a few months and see if there wasn't any improvement. She said overall my teeth were in good shape considering I hadn't been to the dentist in 12 years and had been dealing with several chronic, disabling conditions (no signs of gum disease).

I have been using calcium phosphate based toothpastes and mouthwashes for years (no fluoride, though recently I have started adding some fluoride rinse once a day), so maybe that's why my teeth remineralized.

One thing I did recently was started brushing twice a day. I used to live in the UK, and brushing once a day was more common there and it never made sense to brush twice a day. But I've gotten a really soft toothbrush and I think I'm seeing results from the extra brushing, with no side effects. Youtube is also a great resource for learning good brushing techniques: most people brush in a way that can actually damage your teeth. I've also managed to learn to floss alot better though I'm still dubious of it's benefits, I think it's probably wiser to do it at least once in a while.

 

[FireDragon76]

The National Institute of Health has a balanced treatment of the evidence for flossing:

Don’t Toss the Floss!

It does seem there is some evidence from short-term studies that flossing is beneficial for preventing gingivitis, which as any dentist would tell you, is the early stages of periodontal disease, whose implications are quite serious (gum disease is the leading cause of tooth loss). Other than that, the subject has been poorly studied in peer reviewed literature. However, perhaps that is because the evidence for it is obvious in the practice of actual dentists and hygenists. Just like few pulmonologists would suggest we do a randomized, clinical trial of smoking cigarettes, even though no such study has ever been done. None is needed, nor would it be ethical to do so.

Having considered that, as well as my own experiment with flossing, it's disingenious for the Associated Press to report there is no scientific evidence that flossing is beneficial. Perhaps the Associated Press needs new health reporters actually familiar with the subject matter they report on.

 

[Rajni]

The National Institute of Health has a balanced treatment of the evidence for flossing:

Don’t Toss the Floss!

It does seem there is some evidence from short-term studies that flossing is beneficial for preventing gingivitis, which as any dentist would tell you, is the early stages of periodontal disease, whose implications are quite serious (gum disease is the leading cause of tooth loss). Other than that, the subject has been poorly studied in peer reviewed literature. However, perhaps that is because the evidence for it is obvious in the practice of actual dentists and hygenists. Just like few pulmonologists would suggest we do a randomized, clinical trial of smoking cigarettes, even though no such study has ever been done. None is needed, nor would it be ethical to do so.

Having considered that, as well as my own experiment with flossing, it's disingenious for the Associated Press to report there is no scientific evidence that flossing is beneficial. Perhaps the Associated Press needs new health reporters actually familiar with the subject matter they report on.

Yeah, it makes sense that flossing would have some benefit. Just in my own situation, it has helped keep me from dashing off to an oral surgeon to yank my wisdom-tooth every time it hurt. I would just floss around it a bit more and the pain would disappear. If it comes back at all, it's very mild. So just keeping that area clear of pain-inducing buildup is reason enough for me to floss.

 

[FireDragon76]

I was surprised to learn that the leading European periodontal organization, the European Federation of Periodontology, doesn't recommend routine flossing. They recommend using a variety of approaches, including interdental brushes and mouthwash.

So it does seem outside the US and Britain, there are alot of people that are skeptical of flossing and it's not unusual to see Europeans skipping the practice.

 

[FireDragon76]

After seeing a recommendation by Dr. Joseph Nemeth (a Michigan-based periodontist) on Youtube, I picked up a pack of GUM Soft-Picks. They work great. They are like thin plastic toothpicks coated in a nubby rubber, and come with a little box to carry a few with you wherever you go.

I previously had used the pipe-cleaner style but I didn't like the sensation on metal on teeth contact that would occasionally happen. The Soft-Picks don't do this. They are definitely better than wooden toothpicks.

As far as floss goes, I have the best luck with the black bamboo floss that is trendy now. It slides between most of my teeth fairly easily. I believe this is made in China using rayon infused with nanomolecular charcoal. It doesn't seem to be abrasive, despite being impregnated with charcoal, the feel is alot like silk.

Oral B has a decent spool package of charcoal floss, but lots of other small boutique venders on the Internet are selling them in plastic-free packaging. Sometimes impregranted with candelilla wax, which isn't as good as a blend of waxes and oils (I apply a little lip balm to the floss bobbin to get it to slide easier). The white floss made from corn based polyester, on the other hand, is just terrible, it is rough and breaks easily.

 

[Joyous Song]

I found from a British study that periodontal disease was helped more by eating lower sugar foods and less simple carbohydrates. They put one group on the Keto diet and the other brushed and flossed. the first group was told not to. At the end of that study the first group had less plaque and no cavities and their gums were healthier. Those on just brushing and flossing got worst.

As some plaque was found I suspect that kind of diet with good detail care would work and its has proven so. Last dental appointment I only had plaque in by my wisdom teeth which are harder to reach and even there it wasn't bad.

 

[grasping the after wind]

I never flossed my entire life for 40 years. But all my teeth is fine. Never had cavities, etc. Not even a stain. So I've never been to the dentist since childhood.

I think it depends on what you eat like red meat and sweet desserts can weaken the tooth.

Like a cousin of mine you probably were gifted some specific genetics that gave you natural good dental health. She eats a lot of red meat and until she developed diabetes, she ate a lot of sugary things. No cavities until she was in her 60s and got her first one. No gum problems. Only other dental work was when she fell off her bike and broke a front tooth. Some people are just winners of life's genetic lottery.

 

[FireDragon76]

I found from a British study that periodontal disease was helped more by eating lower sugar foods and less simple carbohydrates. They put one group on the Keto diet and the other brushed and flossed. the first group was told not to. At the end of that study the first group had less plaque and no cavities and their gums were healthier. Those on just brushing and flossing got worst.

As some plaque was found I suspect that kind of diet with good detail care would work and its has proven so. Last dental appointment I only had plaque in by my wisdom teeth which are harder to reach and even there it wasn't bad.

People that eat more fruits and vegetables appear to have less periodontal disease:

Vegetarianism may be great for your gum health but you can still get cavities even if you don't eat meat. That's why I eat a low sugar diet and avoid junk food and sodas now.

 

[JohnPaul88]

If you don't floss how do you get rid of the food stuck in between your teeth?

It'll rot and make your breath stink, and you are more likely to develop Gingivitis if you don't floss.

 

[FireDragon76]

If you don't floss how do you get rid of the food stuck in between your teeth?

A toothpick? I never thought of floss as a particularly efficient way to remove food between teeth after meals, anyways.

 

[JohnPaul88]

A toothpick? I never thought of floss as a particularly efficient way to remove food between teeth after meals, anyways.

I rather floss as sometimes the food is lodged in so deep in between the teeth that a toothpick will not do the trick.