We have been getting many questions from our patients regarding the recent Associated Press article, “Medical Benefits of Dental Floss Unproven” which has been picked up by every major news organization.  We have reviewed the current literature and wanted to share our findings with you.

The federal government has recommended flossing since 1979, first in a surgeon general's report and later in the Dietary Guidelines for Americans issued every five years.  Under the law, the guidelines must be based on scientific evidence. This year, The United States Department of Health and Human Services has dropped flossing as a health recommendation based on the fact that the available scientific studies on flossing do not meet their requirements.

The science is clear that plaque accumulation is the direct cause of dental caries and periodontal disease.  The science is clear that removing dental plaque is associated with health, and conversely, that plaque accumulation is associated with disease.  The concern here is whether flossing is effective in providing the desired health benefit.

One study, “Dental Flossing and Interproximal Caries: a Systematic Review” showed that flossing performed by professionals on children during school days for 1.7 years was associated with a 40% caries reduction but self-performed flossing in young adolescents for 2 years did not reduce caries. This review makes two points very clear. One, that flossing, if performed properly, is very effective, and two, proper flossing technique is not an easy task to master. 

Another study cited, “Efficacy of inter-dental mechanical plaque control in managing gingivitis--a meta-review” “showed weak evidence of unclear or small magnitude to support dental floss” but that “evidence suggests that inter-dental cleaning with interdental brushes is the most effective method for inter-dental plaque removal”.

The take away, after looking at all the evidence, does not change any of our recommendations to our patients.  We recommend using the largest interproximal brush that still fits easily in between the teeth to remove the plaque and biofilm. Small spaces can be handled nicely with GUM® Soft-Picks® or a like product. Larger spaces can best be handled with the use of GUM® Proxabrush® or a similar product.   In cases where there is no space for an interdental brush or pick, floss is the only available method and needs to be used daily.