Say it ain’t so! Have dental professionals and government agencies been spinning a yarn of floss all this time about the importance of flossing our teeth? Why are flouters of flossing gleefully smirking at a new caveat regarding cavity prevention?
Allow me to explain. Every year the federal government releases a bevy of recommended public health guidelines meant to promote health, prevent chronic disease and help people reach and maintain a healthy weight.
Regularly included in those annual guidelines are recommendations on how often to brush and floss our teeth. That is, until now…
New Orleans dentist Levi Spear Parmly is credited with inventing the first type of dental floss in 1819. The first floss patent was issued in 1874 and the American Dental Association (ADA) has promoted flossing since President Teddy Roosevelt became president in 1908.
A surgeon general’s report first recommended flossing in 1979. The importance of flossing was later adopted by the U.S. Department of Health and Human Services, the U.S. Department of Agriculture and was published every five years in the Dietary Guidelines publication.
Flossing one’s teeth has become as synonymous with good oral hygiene as brushing, gargling and regular dental visits.
The decades-old emphasis on the value of flossing apparently has worked because three million miles of dental floss are purchased every year in North America. Worldwide dental floss is a $2 billion-a-year industry within the United States that accounts for half of that glossy figure.
That’s why the recently released Dietary Guidelines for 2016, omitting the recommendation to floss, left many dental professionals collectively scratching their heads. Flossing helps prevent the buildup of plaque by removing food particles that tooth brushing doesn’t always reach, which reportedly prevents cavities and gum disease.
Why is the gloss off the floss?
To unravel this perplexing string of flossing fickleness, look no further than the Associated Press (AP). To be considered legal, government guidelines must be based on scientific evidence.
In 2015, the AP asked HHS and the Department of Agriculture for scientific proof that flossing plays an essential part in maintaining healthy teeth and gums. The AP followed up their requests with a written Freedom of Information Act request. The AP reviewed 25 studies over the past decade and what they found was, to borrow an old school grading term, “incomplete.”
Terms like “weak, very unreliable,” “very low quality” and “a moderate to large potential for bias” were commonly used in describing the available studies used by groups like the ADA and the American Academy of Periodontology.
Much of the problem with the studies was their use of outdated methods and testing groups that were too small. For example, one study reportedly tested only 25 people who flossed just one time. Some studies lasted only two weeks, and in many of those studies the people being tested were flossing incorrectly. (They flossed back and forth rather than up and down the sides of their teeth.)
There was also a question about who was footing the cost of the studies. In many cases it was the same companies that produced and sold dental floss, groups like Procter & Gamble and Johnson & Johnson.
Also, many of the studies cited as unreliable and biased were designed by the floss manufacturers themselves. Can you say “conflict of interest?” The AP can and did, or as our grandpas used to say, “That’s like a fox guarding the henhouse.”
Flossing may not be the magic bullet the federal government and dental professionals often advocate. It’s not like those in the habit of flossing are worse off for the practice, right?
Well…occasionally those who floss and use their hands like partners in a two-man bucking saw lumberjack competition can damage their gums, teeth or dental work. There is also the rare case where someone with weak immunity dislodges bacteria from their teeth and it enters their bloodstream and causes a serious infection.
If you think that dentists and periodontists are going to reconsider recommending flossing just because HHS and the Department of Agriculture have dropped their guidelines, I have a bridge to nowhere made of recycled dental floss to sell you.
Fact: Flossing does help remove plaque.
Fact: Flossing does remove food debris that tooth brushes can’t reach.
Fact: When done correctly, flossing regularly can’t hurt and all types of floss are available at a low cost – especially compared to having a cavity drilled and filled or undergoing periodic scaling and root planing treatment.
Does flossing help prevent gum disease and gum inflammation? It probably helps but objective studies are needed to provide empirical and scientific evidence of those earlier claims. Until then, you’ve got nothing to lose by including flossing in your regular oral hygiene routine.
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Sources: theguardian.com, chicagotribune.com, evergreenorthodontics.ca
Photo source: dentalcaredesign.com, podrebarac
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