Flossgate 2016

Posted on by Jen McGuire | Category Recare, Total Health

By Wendy Briggs, RDH

What in the world is happening in our society? The AP publishes an article saying that science doesn’t support flossing as beneficial, and our world goes crazy! Here are a few headlines:

Dentists Say You Need to Floss. Science Says You Don’t. – Forbes

Studies Show Flossing Likely a Waste of Time – Newser

To floss or not to floss: That is suddenly the question – UCLA

Patients are gleefully flushing their unused floss down the toilet (LOADS of it) and thumbing their noses at dental professionals who are wringing their hands.

What is a Dental Hygienist to do? Let’s see what some of the media has said: Dallas Morning News columnist Mac McCann commented, “This is huge news, life-changing, even. Before, I’d almost never floss and then I’d feel guilty when I lied to my dentist about it. Now, I can skip flossing without shame — other than the shame of being duped for this long.”

Have we really been misleading our patients? After all the AP study said, “The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal.” The news agency also cited a 2015 review that found “inconsistent/weak evidence” for flossing’s benefits.

Let’s focus on the weak evidence the AP referenced. There are plenty of studies that show benefits, but according to the FDA, don’t quite meet the scientific standards for longevity, or sample size. One such study published in 2012, examined this issue. Scientists collected and analyzed randomized controlled trials that compared the effects of tooth brushing and flossing with tooth brushing alone. Twelve studies, encompassing nearly 1,100 subjects were deemed suitable.

Results?  “There is some evidence from 12 studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone.”

Another study published in 2006, the reviewers found that children who had their teeth flossed by a professional hygienist five days per week for 1.7 years had a 40% decreased risk of cavities. But, the weakness in the results comes from the children who flossed themselves. The benefits were not nearly as powerful.

If the evidence for flossing seems suspect, that’s likely because the studies have followed people for a short period of time — some for only two weeks, rather than years.

“The dental profession is behind flossing 100 percent,” said Dr. Paulo Camargo, associate dean of clinical dental sciences and the Tarrson Family Endowed Chair of Periodontics at the UCLA School of Dentistry. “It’s not enough time for periodontal problems to develop,” Camargo said. “In order to evaluate the effect of flossing on the onset and progression of periodontal disease, a prospective study would require that a group of people not floss for a few years. Ethically, you can’t do that type of study.”

The bottom line for dentists and patients is that a lack of strong evidence doesn’t equate to a lack of effectiveness. As doctors of oral health, dentists are in the best position to advise their patients on oral hygiene practices because they know their patient’s oral health status and health history.

So, sadly…patients might be disappointed to know that flossing is still a good idea. As are other methods of cleaning between the teeth. Let’s be honest. We can tell when a patient sits in the chair and opens their mouth whether they floss or not. So, plan on handing out more floss than you may have had to in the past. After all, we need to help patients replace the floss they all flushed down the toilet.

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