Don\u2019t Toss the Floss!
The Benefits of Daily Cleaning Between Teeth
\n ![\"Illustration](\"https://newsinhealth.nih.gov/files/nov2016/images/feature2.jpg\")
\n You may have seen or heard news stories suggesting that you can forget about flossing, since scientists lack solid evidence that you\u2019ll benefit from cleaning between your teeth with a sturdy string. But many dentists may beg to differ. They\u2019ve seen the teeth and gums of people who floss regularly and those who haven\u2019t. The differences can be striking.
\n\u201cEvery dentist in the country can look in someone\u2019s mouth and tell whether or not they floss,\u201d says Dr. Tim Iafolla, a dental health expert at NIH. Red or swollen gums that bleed easily can be a clear sign that flossing and better dental habits are needed. \u201cCleaning all sides of your teeth, including between your teeth where the toothbrush can\u2019t reach, is a good thing,\u201d Iafolla says.
\nIf dentists\u2014and maybe even your personal experience\u2014suggest that regular flossing keeps your mouth healthy, then why the news reports? It\u2019s because long-term, large-scale, carefully controlled studies of flossing have been somewhat limited.
\nResearchers have found modest benefits from flossing in small clinical studies. For instance, an analysis of 12 well-controlled studies found that flossing plus toothbrushing reduced mild gum disease, or gingivitis, significantly better than toothbrushing alone. These same studies reported that flossing plus brushing might reduce plaque after 1 or 3 months better than just brushing.
\nBut there\u2019s no solid evidence that flossing can prevent periodontitis, a severe form of gum disease that\u2019s the leading cause of tooth loss in adults. Periodontitis can arise if mild gum disease is left untreated. Plaque may then spread below the gum line, leading to breakdown of bone and other tissues that support your teeth. Periodontitis develops slowly over months or years. Most flossing studies to date, however, have examined only relatively short time periods.
\nAnother research challenge is that large, real-world studies of flossing must rely on people accurately reporting their dental cleaning habits. And people tend to report what they think is the \u201cright\u201d answer when it comes to their health behaviors\u2014whether flossing, exercising, smoking, or eating. That\u2019s why well-controlled studies (where researchers closely monitor flossing or perform the flossing) tend to show that flossing is effective. But real-world studies result in weaker evidence.
\n\u201cThe fact that there hasn\u2019t been a huge population-based study of flossing doesn\u2019t mean that flossing\u2019s not effective,\u201d Iafolla says. \u201cIt simply suggests that large studies are difficult and expensive to conduct when you\u2019re monitoring health behaviors of any kind.\u201d
\nWhile the scientific evidence for flossing benefits may be somewhat lacking, there\u2019s little evidence for any harm or side effects from flossing, and it\u2019s low cost. So why not consider making it part of your daily routine?
\nTalk to your dentist if you have any questions or concerns about your teeth or gums. If flossing is difficult, the dentist may recommend other ways to remove plaque between teeth, such as with a water flosser or interdental cleaners. \u201cIf you need help learning how to floss, or if you don\u2019t think you\u2019re doing it right, your dentist or hygienist will be happy to show you how,\u201d Iafolla says. \u201cIt helps to know the proper technique.\u201d
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References: Flossing for the management of periodontal diseases and dental caries in adults. Sambunjak D, Nickerson JW, Poklepovic T, et al., Cochrane Database Syst Rev. 2011 Dec 7;(12):CD008829. doi: 10.1002/14651858.CD008829.pub2. Review. PMID: 22161438.
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