Should You Still Floss? Here’s What the Experts Say

Should You Still Floss? Here’s What the Experts Say

Even though a recent report suggested there is no health benefit to flossing, health experts say that you still need to clean in between your teeth.

That recent report, from the Associated Press, concluded that there isn’t a compelling reason to floss: The recommendation for flossing lacks any evidence that flossing actually helps, the report said. And, a recommendation that people floss has been removed from the latest U.S. government dietary guidelines, the report added.

Live Science raised questions about flossing to several experts, including whether it’s OK for people to stop flossing. Here’s what they said (answers have been edited). [9 Healthy Habits You Can Do in 1 Minute (Or Less)]

Dr. Tim Iafolla, a dentist and public health analyst at the National Institutes of Health’s National Institute of Dental and Craniofacial Research:

Weak evidence for flossing doesn’t necessarily mean that flossing is ineffective, it just means there isn’t positive evidence for flossing. Flossing is a low-risk and low-cost procedure, and because clinical studies show that it’s effective when it’s done well, we just don’t have much hesitation to say go ahead and do it. It’s not going to hurt.

As a dentist, I have no hesitation still telling my patients to floss. Dentists can tell immediately, looking at a patient’s mouth, whether they floss or not.

But if you’re feeling pain while you’re flossing, then you’re probably being a little too aggressive at what you’re doing. The goal is to get the floss kind of wrapped around the part of the tooth that is next to the adjacent tooth, so you want to kind of wrap the floss around the neck of the tooth and run it up and down, so that you’re dislodging the food and the plaque and the bacteria that are in that space.

The goal is to make sure that you’re flossing effectively, and then I think the results will be fairly clear to the patients, and to the patients’ dentists who are looking in their mouths afterwards. I think removing plaque is a good thing and anything you can do that helps that is something you should be doing.

Dr. Tim Pruett, a dentist in Tavares, Florida, and the inventor of the Flossolution, a sonic energy-powered flossing system:

There are five surfaces on each tooth, including three that a brush can clean (the front, back and top or bottom of the tooth), and two that require flossing to clean (the sides of the tooth, that are adjacent to other teeth).

At a basic level, dentists and hygienists recommend flossing as a preventative approach for two reasons. One, to help prevent tooth decay that can originate from the presence of acid-producing bacterial biofilm between teeth. Two, to help prevent the gingivitis that can stem from an immune system-mediated inflammatory response to the presence of bacterial biofilm between teeth. [10 Medical Myths that Just Won’t Go Away]

Gentle, mechanical cleaning is foundational to good oral hygiene. You have to mechanically dislodge or disrupt the pathologic biofilm (plaque, gunk, whatever you want to call it) that causes acidic destruction in tooth decay and inflammatory destruction in gum disease.Butflossing incorrectly (sawing floss between teeth) can actually damage the edges of the gums. So if you’re not flossing correctly, absolutely don’t floss at all.

However, gentle and correctly done oral hygiene, that includes both brushing and cleaning between your teeth, will help prevent problems. Maintaining clean and healthy teeth is a best-practice approach to maintaining lifelong oral function and preventing tooth loss.

Dr. Edmond Hewlett, a spokesman for the American Dental Association and professor at the UCLA School of Dentistry:

The Department of Health and Human Services’ decision to not include flossing in its recent recommendations should not indicate that the importance of flossing is any less than it ever has been. What it does allude to is the difficulty of conducting a study to specifically provide unequivocal proof of the effect of flossing. Just because there is a lack of strong evidence, that does not mean that there’s no effectiveness.

We know that plaque, the bacteria in dental plaque, cause gum disease. We know that, that’s not in dispute. It’s on the teeth, it gets on the teeth every day.

I’ve seen the benefits of flossing in my own mouth, when I’ve had areas that I would miss. I’ve certainly seen it in patients as well, the difference between the inflammation in the gums when a person flosses regularly and when they don’t.

In the case of flossing, or interdental cleaning, these procedures are very low risk. You have to go out of your way to hurt yourself doing this type of cleaning. Even if there is a small benefit, it’s a valuable one to have available to our patients given that about half of Americans have periodontal disease. So because flossing has such a low risk of causing problems, the risk-benefit ratio definitely is in favor of flossing and other interdental-cleaning methods.

The recommendation of the ADA continues to be that patients brush twice a day with a fluorinated toothpaste, floss or use interdental cleaning once a day, and see their dentists on a regular basis. That still is the best advice we can give patients as far as maintaining their oral health.

These responses have been edited for length and clarity. Original article on Live Science.

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