When it comes to orthodontics health and habits, it always seems that someone is telling us what we can and cannot do. Perhaps that is why those studies that make us feel better about not always following the rules makes us feel better.
Findings published for the past decade about the effectiveness of flossing on tooth decay has been mixed. Some studies have found that it has no relation to tooth decay while others insist that tooth health is directly related to nothing more than flossing.
There seems to be some truth to the scientific findings that the shame we all get by our dental hygienist may not be well founded. Could it be that we need not feel ashamed that flossing is not on our lists of to-dos?
The research shows that if you don’t make a daily routine out of flossing, you may not be alone. A reported ten to forty percent of Americans are the only ones who take to their teeth with the thin line of string as recommended.
What about the other sixty to ninety percent? Could they know something that those who hold fast to good habits don’t? Could it be possible that flossing your teeth has no bearing on your dental health? Some research would indicate yes.
There have been hundreds of various scientific studies done on the relation of flossing and dental health. The problem is that they have all been fraught with inconsistencies, researcher bias, and poor experimental design such as self-reporting.
No one wants to admit that they may not always take the high road twice a day. When you use self-reporting, you are always going to run into participation issues. In the past ten years, there have only been three various experimental designs that hold any scrutiny, and they still are not the clear vision of acceptance among the dental community.
Ten years ago there was a study done to focus on the habits of children between the ages of four years old and thirteen. Reviewers found that when children had their teeth flossed, by a professional (which was key), five or more days a week, for more than a year and a half, they have a forty percent decrease in the risk of cavities than their cohorts who did not perform flossing routines. Those children who were taught to do their flossing, however, showed no benefit from flossing.
So, what was the problem with the conclusions found? There were confounding differences between the participants for other factors such as tooth brushing habits and fluoride as well. Not being able to rule out other factors influencing the results, the findings can not be extrapolated to the general public.
When a team from the University of Applied Sciences in Amsterdam followed up with their own version of the experiment, they found that there were no benefits to flossing on either plaque or gingivitis. In addition, there was no scientific finding that flossing correlated directly with tooth health.
In 2012, the debate raged on. Another randomized control trial was undertaken to examine the effects of flossing and tooth brushing against tooth brushing alone. After studying over 1100 participants, what they found was that a reduction in plaque and gingivitis was so minuscule that it was barely scientifically significant.
What they did find was that using mouthwash regularly may have more effect than taking to the gums with floss. The only thing that did have a real impact on tooth decay and dental health seemed to be the frequency of using mouthwash.
Those who continue to insist that flossing is critical to gum and tooth health say that the reason the studies don’t support their conclusion is that the participants in studies just aren’t doing it correctly. Floss snobs around the globe refuse to yield to what the science continues to show us; flossing may not be the end all be all for tooth health.
If dentists want to foster the health of their client’s teeth, it seems more important that they encourage good habits like using mouthwash twice a day. They are more likely to get people to comply when using recommendations, which are shown to work, and that are less invasive. The next time that you hit the dentist chair fear not, simply cite the lack of evidence that flossing does what it sets out to do and hang your head high, even with their fingers in your mouth.