Health

Don’t toss the floss

Despite recent reports, dentists say there is good reason to clean between your teeth.

You may have seen or heard news stories suggesting that you can forget about flossing because scientists have said there is no solid evidence that you’ll reap any benefits. But many dentists may beg to differ. They say don’t throw away the string just yet. They have seen the teeth and gums of people who floss regularly and those who haven’t and say the differences can be striking.

“Every dentist in the country can look in someone’s mouth and tell whether or not they floss,” said Dr. Tim Iafolla, a dental health expert at National Institutes of Health. “Cleaning all sides of your teeth, including between your teeth where the toothbrush can’t reach, is a good thing.”

Dentists say red or swollen gums that bleed easily can be a clear sign that flossing and better dental habits are needed.

Dentists say red or swollen gums that bleed easily can be a clear sign that flossing and better dental habits are needed.

If dentists (and maybe even your personal experience) suggest that regular flossing keeps your mouth healthy, then why the all news reports to the contrary? It’s because long-term, large-scale, carefully controlled studies of flossing have been somewhat limited.

Researchers have found modest benefits from flossing in small clinical studies. For instance, an analysis of 12 well-controlled studies found that flossing plus brushing teeth toothbrushing reduced mild gum disease, or gingivitis, significantly better than toothbrushing alone. These same studies reported that flossing plus brushing might reduce plaque after 1 or 3 months better than just brushing.

But there’s no solid evidence that flossing can prevent periodontitis, a severe form of gum disease that’s the leading cause of tooth loss in adults. Periodontitis can arise if mild gum disease is left untreated. Plaque may then spread below the gum line, leading to breakdown of bone and other tissues that support your teeth. Periodontitis develops slowly over months or years. Most flossing studies to date, however, have examined only relatively short time periods.

Another research challenge is that large, real-world studies of flossing must rely on people accurately reporting their dental cleaning habits. And people tend to report what they think is the “right” answer when it comes to their health behaviors—whether flossing, exercising, smoking, or eating. That’s why well-controlled studies (where researchers closely monitor flossing or perform the flossing) tend to show that flossing is effective. But real-world studies result in weaker evidence.

“The fact that there hasn’t been a huge population-based study of flossing doesn’t mean that flossing’s not effective,” Iafolla said. “It simply suggests that large studies are difficult and expensive to conduct when you’re monitoring health behaviors of any kind.”

While the scientific evidence for flossing benefits may be somewhat lacking, there’s little evidence for any harm or side effects from flossing, and it’s low cost. So why not consider making it part of your daily routine?

Talk to your dentist if you have any questions or concerns about your teeth or gums. If flossing is difficult, the dentist may recommend other ways to remove plaque between teeth, such as with a water flosser or interdental cleaners.

“If you need help learning how to floss, or if you don’t think you’re doing it right, your dentist or hygienist will be happy to show you how,” Iafolla said. “It helps to know the proper technique.”

Here are a few tips from NIH on how to care for your teeth and gums:

  • Gently brush your teeth on all sides with a soft-bristle brush and fluoride toothpaste. Use small circular motions and short back-and-forth strokes.
  • Brush carefully and gently along your gum line.
  • Lightly brush your tongue to help keep your mouth clean.
  • Clean around your teeth with dental floss. Work the floss gently between the teeth until it reaches the gumline.
  • Curve the floss into a C shape against one tooth and slide it into the space between the gum and the tooth. Move the floss up and down. Do this for both sides.
  • If you have trouble flossing, a floss holder or other cleaning device may help.
  • Rinse after you floss.

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