Don't Believe the Hype: Dental Groups Say Flossing Still Essential

Dental industry groups are working hard to tamp down public confusion after a widely circulated news report this week suggested that flossing is effectively useless.

Flossing suddenly became a hot topic of conversation Tuesday when the Associated Press (AP) published an investigative report asserting that flossing has little or no effect on gum disease. The AP based the claim on five studies from the past 11 years, each of which found little or weak evidence to support flossing.

The research is important because the government is required to offer a scientific basis for the federal dietary guidelines it issues every five years. The government has recommended daily flossing since 1979.

Last year, the AP filed a Freedom of Information Act request with the government seeking the scientific rationale behind the flossing recommendation. Instead of directly responding to the request, the government quietly removed the flossing recommendation from its 2016 version of the guidelines. When asked about the change, the government told the AP that there wasn’t a sufficient amount of research to justify flossing.

The AP’s report—under the headline “Medical Benefits of Dental Floss Unproven”—quickly boomeranged around social media, with major publications like Time declaring flossing a “waste of time.”

However, dental organizations were unconvinced.

The American Dental Association (ADA) quickly responded with a statement calling interdental cleaners “an essential part” of oral health and affirming its recommendation that patients brush for two minutes twice a day with fluoride toothpaste and use an interdental cleaner like floss once per day.

“Cleaning between teeth removes plaque that can lead to cavities or gum disease from the areas where a toothbrush can’t reach,” the ADA said. “Interdental cleaning is proven to help remove debris between teeth that can contribute to plaque buildup.”

The ADA also noted that flossing’s effectiveness can be undermined by poor technique.

In its response, the American Academy of Periodontology (AAP) said the studies cited by the AP are insufficient.

“Because the development of periodontal disease is slow in nature and because a variety of factors can impact its progression, studies that examine the efficacy of daily flossing are best conducted over a number of years and among a large population,” the AAP said. “Much of the current evidence does not utilize a large sample size or examine gum health over a significant amount of time.”

The AAP also said many of the studies didn’t measure inflammation or clinical attachment loss, which it says are the best markers of periodontal disease.

While both the ADA and the AAP were resolute on the importance of cleaning between your teeth, the ADA did offer one bit of wiggle room. Patients who don’t like flossing don’t have to use floss—they can also use other interdental cleaners, such as picks and water irrigation.