To floss or not to floss?


  Posted by: Dental Design      3rd August 2014

Prof Damian Walmsley, scientific adviser to the British Dental Association, has responded to an investigation by Associated Press (AP) in the US that says there is insufficient proof that flossing is beneficial to oral health. The US Department for Health and Human Services and Agriculture admitted in a letter that the benefits of flossing had never been properly researched. This would seem to echo APs research, which concluded that only a small number of people have been surveyed, with evidence for flossing ‘very low quality’ with, ‘a moderate to large potential for bias’.

Yesterday, the American Dental Association (ADA) said, contrary to the AP report:-

“Cleaning between teeth removes plaque that can lead to cavities or gum disease from the areas where a toothbrush can’t reach.

Interdental cleaning is proven to help remove debris between teeth that can contribute to plaque build-up.”

Prof Walmsley says: “The difficulty is trying to get good evidence. People are different and large studies are costly to do… until then you can’t really say yes or no.” He added that “more sophisticated trials” were needed.

The British Society for Dental Hygiene and Therapy (BSDHT), however, has emphasised the need for dental professionals to continue to encourage their patients to practise interdental cleaning.

Michaela ONeill, President of the BSDHT, said: “Although there has been no conclusive proof to show that flossing is beneficial to oral health, there is evidence which shows that regular interdental cleaning, with interdental brushes plays an important role in our oral health routine.

“Tooth brushing alone only cleans three of the five surfaces of our teeth, so cleaning between our teeth is a critical part of good oral hygiene as it helps to prevent gum disease by removing plaque from any areas missed by brushing alone.

“In recent years’ gum disease has been linked with serious health conditions such as diabetes, stroke, cardiovascular disease, poor pregnancy outcomes and even dementia.

“Regular interdental cleaning removes the biofilms that develop in-between teeth. This is commonly called plaque and hosts various microorganisms which, if left in situ, can lead to dental decay. It is this plaque that we aim to remove daily.”

Ms ONeill continued: “Although flossing has not been proven to be effective, one of the major problems of the research so far is that it makes some conclusions which cannot be applied to all patients. Patients are individuals and consequently have different needs.

“For example, if we consider a patient who suffers from an autoimmune disease, or an elderly patient, or perhaps a very young patient, we understand that they are all at a greater risk from opportunistic bacteria in their mouths, which can lead to an increased risk of infection. For these groups, who are not widely sampled within the existing research, regular interdental cleaning can be even more effective.

“Reports that flossing can actually be damaging to oral health are also incredibly misleading. If you have any concerns or questions you should raise these with a member of your dental team.”

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