Flossing is bullshit

The Associated Press filed Freedom of Information requests with the US government to find the evidence behind the Surgeon General's admonition to floss regularly for dental health and found that there was no good evidentiary basis for flossing.

Subsequent to this, the federal guidelines on dental health were revised, and the recommendation to floss was silently removed. The government sent a letter to the AP confirming that the government flossing recommendations had not been based on any research.

The American Dental Association and American Academy of Periodontology still insist that flossing is evidence-based, but only cite small, short-run, old, and badly designed studies in support of that position. The big floss companies -- Procter & Gamble and Johnson & Johnson -- were also at a loss to cite any reliable evidence for flossing.

The AP looked at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings? The evidence for flossing is "weak, very unreliable," of "very low" quality, and carries "a moderate to large potential for bias."

"The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal," said one review conducted last year. Another 2015 review cites "inconsistent/weak evidence" for flossing and a "lack of efficacy."

One study review in 2011 did credit floss with a slight reduction in gum inflammation — which can sometimes develop over time into full-fledged gum disease. However, the reviewers ranked the evidence as "very unreliable." A commentary in a dental magazine stated that any benefit would be so minute it might not be noticed by users.

Medical benefits of dental floss unproven [Jeff Donn/AP]

(via Metafilter)

(Image: How To Floss - Mouth Healthy - ADA , T Sona Tacvorian, DMD - TST Dentistry)

Notable Replies

  1. Well, okay, even assuming that maybe flossing doesn't have a major effect on plaque build-up, NOT flossing does have the major effect of leaving rotting food stuck between the teeth, awful breath, and gum irritation. So why in the world is the AP pursuing this? Are they looking to take down the Big Floss lobby?

  2. Yri says:

    Lack of evidence doesn't mean it's not actually helpful. It definitely reduces my gum inflammation when I do it.

    That, of course, is anecdotal evidence, but since it's my own anecdote, it's good enough for me.

    I would bet that more carefully run studies would demonstrate benefit, possibly only to certain sorts of subjects (prone to gingivitis, for example, like I am). But science, you know - any assumption I make may be wrong.

  3. My own anecdotal evidence also says flossing is very effective at improving my gum health and eliminating bad breath. Maybe it's not studied much because it's so obvious that it's effective.

  4. Flossing, for me, has the desired effects cited by the posters above. And at least for now, the most important effect is that if I floss regularly, and even step it up the week before a dental visit, my hygienist draws a lot less blood and shame from me.

  5. Some years ago, not being a flosser and having dodgy gums, a bit of meat got tucked between two of my teeth, rotted over a few days, and introduced some really nasty bacteria into my bloodstream, causing a near-fatal endocarditis. It's not statistically significant, but it's significant to me. So I floss now.

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