healthbriefs
Argument for Flossing T
by Jonathan Richter, DDS, FAGD
he burning question in the news last week was this: Should we bother flossing? The answer for decades has been “of course.” And it’s
likely you’ve heard something similar from your dentist. But, while the importance of flossing may have been widely accepted, the evidence supporting it turns out to be surprisingly thin. At least that’s the conclusion of health experts that developed the recently re- leased Dietary Guidelines for Americans, 2015- 2020. These guidelines are issued every five years by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture “to reflect the current body of scientific evidence on nutrition, food, and health.” The 2010 edition includes this sentence: “A combined approach of reducing the amount of time sugars and starches are in the mouth, drinking fluoridated water, and brushing and flossing teeth, is the most effective way to reduce dental caries.” But, the latest edition leaves this sentence out. That’s because the authors of these guidelines could not find con- vincing evidence to support flossing, and the guidelines are supposed to be evidence-based. According to reviews of the evidence published in 2011 and 2015, there is minimal, short- term, and generally unreliable evidence that flossing might reduce gum inflammation, but no convincing evidence that it promotes plaque removal or prevents tooth decay or dental caries (cavities).
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Is the lack of evidence for flossing big news?
I’ve seen several eye-grabbing headlines regarding this devel- opment, including: - “Feeling Guilty About Not Flossing? Maybe There’s No Need” (New York Times)
- “Guilty No More: Flossing Doesn’t Work” (Mother Jones)
Jonathan Richter, DDS, FAGD
- “A Big Problem with Flossing” (CBS News) It is surprising to learn that there is so little evidence to support such a well-accepted bit of health dogma. Yet, there may be less here than meets the eye. In fact, I think these headlines (and some of the com- ments I’ve heard from friends and family) miss the mark on this flossing kerfuffle. There’s a saying in the science world that “absence of proof isn’t proof of absence.” That is, just because the evidence isn’t there doesn’t mean an idea is wrong. Unproven is unproven, not disproven! A cousin emailed me to say, “Good, now I can feel less guilty about not flossing.” I’m all for people feeling empowered with their health deci- sions (especially if they are well-informed). But the experts that removed the flossing recommendations from the di- etary guidelines did not find flossing was useless. They only found that flossing had never been well-studied and that the evidence to date was inconclusive. If my cousin has gum disease, flossing might be important for his oral health. Floss- ing is low-cost, low-risk and has potential (and biologically plausible) health benefits; it seems premature to conclude it is useless. In fact, it may very well be a good idea just wait- ing to be well-studied.
So, to floss or not floss (without guilt)?
The obvious next step is to recommend that researchers study the health impact of flossing. With a well-funded, well- designed study, it may be easy to prove that, in fact, flossing is good for your oral health, and I would not be surprised if it turned out to be good for you in other ways, since gum disease has been linked to an increased risk of cardiovascu- lar disease, diabetes and stroke. But that’s getting ahead of the story; let’s first prove that daily flossing is at least good for your oral health. I’m not going to wait for the research; I’m going to keep flossing. I hope my cousin does, too.
Source: Jonathan Richter, DDS, FAGD, of Cardiodontal, located at 310 E. Shore Rd., Ste. 101, Great Neck. For more information or to schedule an appointment, call 516-282-0310. See ad on back cover.
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Long Island Edition
www.NaturalAwakeningsLI.com
Photo Courtesy of Darren Muschett
www.skudinsurf.com
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