The Canadian Dental Association advises brushing twice and flossing teeth once every day. In 2018, a Canadian Community Health Survey showed that only less than half (43 percent) of Canadians aged 12 and up flossed once daily. Even smaller was the percentage of the population who completely met the Canadian Dental Association’s daily dental care advice (37.5 percent).
What Studies Say
Are more than half of Canadians right in skipping flossing?
An article published on Associated Press (AP) says “maybe”, which made waves among oral health care professionals in 2016. The article cites 25 studies that compared the effectiveness of brushing alone and the combination of brushing and flossing. AP concludes that the collected data are not in favour of flossing. There is no scientific evidence in the selected studies that prove flossing provides medical benefits that you can’t get by brushing alone.
What Dentists Say
Wayne Alderedge, president of the American Academy of Periodontology, still encourages flossing to prevent gum disease like gingivitis. He explains, “[Brushing without flossing is] like building a house and not painting two sides of it. Ultimately those two sides are going to rot away quicker.”
Timothy Hempton, a professor at Tufts University School of Dental Medicine, still recommends flossing to get rid of bits of food and other substances stuck between teeth. He says that it’s important to floss and that it is the most effective way to remove material that toothbrushes can’t reach.
Most dentists seem to be in favour of flossing, but there are also a few who express doubt. Damien Walmsley, the scientific adviser to the British Dental Association, says, “It’s important to tell people to do the basics. Flossing is not part of the basics.”
The Effectiveness of Flossing in Plaque Removal
The experts seem to be divided on the matter, so let us get our facts right and make the judgment by ourselves.
Flossing does not protect your teeth from cavities, but it does lessen your risk of getting gingivitis. (To prevent cavities, you have to use fluoridated toothpaste and drink fluoridated water.)
As said previously, most dentists advise their patients to use floss to remove plaque between teeth. Plaque is the film of bacteria that accumulates on the teeth’s surface. Gingivitis, characterized by swollen, sore, and red gums, occurs when there is excess plaque at the base of the teeth. In severe cases, this may result in periodontitis that damages the bone supporting your teeth and causes tooth loss.
However, it remains unclear how effective flossing is in terms of preventing gingivitis. Among the studies AP collected was a 2015 review that said, “The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal.”
In another study in 2018, Georgios Kotsakis, a researcher at the University of Texas, San Antonio, reports that they saw flossing removed only a minimal amount of additional plaque between teeth.
Should You Put Down That Floss Now?
The short answer is “No”. Elemental science writer David Freedman says that the data does not suggest you should give up flossing now. He looked into the previous studies and found the following problems:
- Unreliable data. Participants might have given incorrect information about their personal dental hygiene habits. Angelo Mariotti, the chair of periodontology at Ohio State University, suspects that “they’re embarrassed to admit they don’t do it.” The chair also states that according to studies, 1 out of 4 people lie about flossing.
- No control groups. When conducting these studies, the researchers could not insist that a number of participants should not floss, since flossing is still being upheld as a standard oral health care practice. It would go against their conscience to advise participants to not follow the recommendation of trusted health institutions. The researchers, then, could not set up a control group by which to compare the performance or oral health condition of another test group, who should be flossing.
- Incorrect technique. Flossing properly takes a while to perfect. The participants might not have been practicing the right floss technique during the studies. Diane Melrose, the chair of dental hygiene at the University of Southern California School of Dentistry, claims that 90 percent of the patients who tell him they floss don’t know how to do it correctly.
Simply, you should continue to floss so long as you learn how to do it right.
How to Floss
Here is a step-by-step guide from the Canadian Dental Association on how to floss properly:
- Get a piece of floss that is as long as the distance from your hand to your shoulder. Wrap it around your index and middle fingers with about a two-inch space between both.
- Slide the floss between your teeth and wrap it into a “C” shape around the base of the tooth and gently under the gumline. Carefully scrape the tooth from base to tip twice or thrice.
- Don’t forget to floss both sides of every tooth, especially the backs of your last molars. Move to an unused segment of the floss as it wears and takes up bits of food and other substances. When you are done, roll the floss into a ball and throw it into the garbage. Never flush it down the toilet.
Steer clear of the floss varieties that are thin and slippery. These types have the tendency to run over plaque. Choose the thicker, rougher types for a better clean and to save you time.
It’s a little more challenging to floss with braces, however, it’s just as important.
With the right technique, flossing can prove quite effective. Contrary to the selected studies by AP, several studies since the 70s show that flossing is effective when done properly. Researcher Kotsakis admits that flossing consistently works well when done under lab conditions.
Alternatives to Flossing
Are you still worried about certain dental issues and remain unconvinced that flossing will do it for you? Or do you find it too tedious and time-consuming to practice the correct floss technique? You can opt for alternative tools that provide the same medical benefits:
- Water Flosser – One such alternative is the water flosser or oral irrigator, which you might recognize by the brand Waterpik. This is a handheld device that spews high-pressure water to floss between teeth. When comparing regular floss vs. the Waterpik, the latter is more effective in reducing gingivitis and gingival bleeding
- Interdental Brush – The interdental brush specifically designed to reach the spaces between your teeth that are hard to reach with a regular brush. Interdental brushes work best for people with wider gaps between their teeth.
Different People, Different Treatment
Don’t be afraid to tailor your dental hygiene practice to suit your comfort and needs. The effect of dental practices and tools vary among different people.
Pick a flossing tool that you can use with ease and incorporate into your daily and nightly routine without any difficulty. Unlike some clothes, dental hygiene practices and tools aren’t “one size fits all.” Dentists and patients alike should take a personalized approach at flossing techniques and determine the most effective methods through trial and error.
If you need more advice on what works best for your oral health, consult our friendly dentists at Cosmo Dental Centre for a personal checkup. We offer a variety of dental services and can educate you on dental care. Visit us at 373 Clarke Road, London, Ontario, N5W 5G4 or give us a call at (519) 659-2767.