Should You Floss?

The Associated Press came out with a story a couple of days ago with the headline, “Medical benefits of dental floss unproven”. Because flossing and dentist visits are such hated past-times, many media outlets seized on this story and claimed that you can stop flossing!  Headlines like “Tell your dentist to suck it” abounded. Hey, don’t get me wrong. I’d be super excited if we actually had found out that flossing doesn’t work and nobody needed to do it too. One less thing for me to do and I could tell my hygienists to stop hounding my patients about it.

Here’s the funny little secret though. Unproven, doesn’t mean ineffective. Dentists have been notoriously behind the times in adopting evidence based practices. Certain topics just haven’t been studied well. The existing studies all had significant problems such as extremely short time spans, difficulties controlling variables, and no measurements on the actual important indicators of gum disease. Gum disease and decay is process that occurs over years and years, not days or months. Studying this can be extremely difficult because getting some to comply with flossing instructions over this time frame can be nearly impossible. All that said, one of the other main reasons it hasn’t been studied is because it’s benefits are so readily apparent to any dentist, hygienist, or any regular person who has taken the time to start flossing regularly.

Don’t believe me? Take this challenge. First look at your gums, brush them hard, poke them slightly and watch them bleed. If you don’t floss, this will more than likely be the case. Now, go ahead and floss for two weeks straight and then do the same thing. Guess what, they won’t bleed easily anymore! You literally have to stick a sharp instrument into them really hard to make them bleed. I’ve seen this in patient after patient after patient. I’ve seen this on myself personally. Ask any dentist or dental hygienist. They’ll tell the same thing. I know that personal experience doesn’t rise to the level of scientific evidence, but the professional consensus in the dentistry community is almost unanimous in support of flossing.

Bleeding of the gums with slight pressure (say from brushing or occasional flossing) isn’t normal. Any other area of your body that bled spontaneously or easily and you’d be off running to your physician. Why isn’t this the case with your mouth too? Flossing prevents this.

Here are some other common sense benefits to flossing that all dentists know…

• It cleans out food from between your teeth. Don’t floss for a couple days then floss again. You’ll pull a bunch of rotting food out from between your teeth when you do. You can easily see this on the floss. At best, this rotting food will cause you to have bad breath. At worst it can cause gum disease and cavities. I consistently see people develop cavities in areas where food gets stuck in between the teeth.
• Most people who don’t floss build up significant tartar between their teeth, under the gumline. Floss or a waterpik is the only way to clean the plaque out before it turns hard and calcifies into tartar.
• Tartar under the gumline causes additional inflammation of your gums and eventually leads to bone loss around your teeth. I’ve never seen anyone develop gum disease who flosses regularly (unless there was some other specific health problem at play).
• Gum health is linked to overall health. This includes diabetes, heart disease, and certain types of cancer. Unlike flossing, the literature on this is solid.

After all this, if you still don’t want to floss, by all means go ahead. I’ll see you in 10 or 15 years needing some serious dental work. You’ll wish you had taken the 30 seconds a day to floss instead of believing hyped up media stories meant to sell clicks and advertising space.