While flossing used to be quite an important part of oral and dental health in the past it seems to have decreased in popularity as far as the ‘Dietary Guidelines for Americans’ is concerned. The U.S. departments of Health and Human Services and Agriculture issue these guidelines every five years. So, why is this happening to flossing? Well, it could be because there isn’t much evidence regarding whether or not flossing plays a huge role in keeping gums and teeth healthy.
According to Tim lafolla, who happens to be a dentist with the National Institute of Dental and Craniofacial Research (which is part of the National Institutes of Health), “In large epidemiological studies, the evidence for flossing turns out to be fairly weak.”
Even though lafolla wasn’t part of drafting the issues guidelines he is aware of the problems regarding flossing research. “The condition we’re trying to prevent, which is gum disease, is something that takes years to develop, and most of the studies only last for a few weeks or months. So, the evidence that we gather from these studies is fairly indirect. We can look at bleeding gums, we can look at inflammation, but we have to extrapolate from that evidence to gum disease.”
Back in 2011, a Cochrane oral hearth review, which included 12 studies done of the effects of flossing, found out that the studies were of poor quality and the results couldn’t be viewed as reliable. Flossing could help reduce gingivitis if done regularly with brushing but when compared to brushing alone there wasn’t strong evidence that showed flossing to help reduce plaque. The researchers who conducted the review shared a conclusion that said that the trials weren’t long enough to observe the impacts of flossing on tooth decay and other long-term health impacts.
The lack of research seems to have led flossing to not be included in the guidelines released for this year. A spokesperson with the U.S. Department of Health and Human Services came forward to help clear some misconceptions. “Since neither the 2010 nor 2015 Advisory Committees reviewed evidence on brushing and flossing teeth, the authors of the current edition decided not to carry forward the information on brushing and flossing included in past editions of the guidelines. They were not implying that this is not an important oral hygiene practice. It is also important to note that, although dental floss was mentioned in past editions of the guidelines, it was most likely identified as a supporting recommendation along with brushing teeth, with the primary emphasis being on the nutrition-based recommendation to reduce added sugars.”
Whatever the reason some dentists don’t like the fact that flossing hasn’t showed up in the guidelines. “It was a surprise because it’s almost something that’s ingrained in our DNA as dentists,” says Joan Otomo-Corgel. Joan is a periodontist with the American Academy of Periodontology, practicing in L.A. She further went on to say that a lot of people don’t like flossing and her concern in that flossing not being included in the guidelines will further strengthen their stance. “So there is a taboo. And my concern is that the public picks up on this and says ‘Oh, flossing is not a benefit. That means I don’t have to do it.”
She added that in her 32 years of practice she has found flossing to help get rid of bacteria that grows in the spaces between the teeth. This prevents infections and other possible health problems. “Biofilms are live. I mean, you look at it under a microscope, you have swimmers. You have different types of bacteria that form, and the longer they stay, the more virulent they become.” Getting rid of flossing completely makes her worried about an individual’s overall health in the long run.
Right now more research is required to see the actual benefits of flossing, if there are any, in studies that follow individuals long-term.