Should You Floss?
Much of the dental community is upset about the recent Associated Press report questioning the efficacy of flossing. Is the Flossing Study a disservice or a blessing in disguise? I choose to look at it as a blessing. What else could possibly bring flossing into the forefront of the social media more than something like this? Within 24 hours of it coming out, the article was sent to me by several friends and it also came up at a dinner party I was at last night. What a great opportunity to have a conversation with your patients, friends, and family!
This is how I look at the issue. Granted, there are surprisingly few well controlled studies supporting flossing. You may ask “why is this”? The answer is easy. Periodontal disease, in most cases, is a slow progressing disease that can take years to manifest itself. Once it does manifest itself, the damage is irreversible.
How would one go about studying this? From a purely research perspective you would set up a double blind study, the gold standard of clinical research. You would have to standardize a brushing technique, control as many variables as possible, things like smoking, diet, habits, alcohol consumption, social issues, etc. Then you would have to have half the group floss and the other half not floss. The study would go on for years or at least until you see a trend. By then, a certain amount of irreversible destruction would have taken place. You could never get a study like this approved and if you could, it would be unethical.
So how do you respond to the inevitable naysayers? Well, there are several points I would make:
Plaque control is not an absolute. It’s not a situation where you either get the plaque off or you don’t. There are “levels” of plaque control and there are “levels” of disease susceptibility. You don’t need to remove all the plaque, just enough to stay below the threshold of disease. Flossing removes interproximal plaque. Not all of it, there are concavities that floss won’t touch, but most of it. A point in your favor for staying healthy.
Flossing is not a major time commitment and certainly does not create a financial hardship. So why not put the cards on your side of the table?
It feels good to have flossed. I, for one, cannot stand stuff stuck between my teeth and I doubt others care to look at stuff stuck between my teeth!
I bet all of you could add to this list. So – I, for one, will continue to floss until such time as someone proves to me that it is actually harmful!