Despite being a decidedly unglamorous topic, flossing has managed to make it into the mainstream news. How did this happen? Tell people they don't need to floss anymore! A review published by the Associated Press in August 2016 states that there's little evidence to support the effectiveness of floss, so why do dentists worldwide still recommend it?
For the uninitiated, the first few weeks of learning to floss are fiddly, time-consuming, and frustrating. It's no surprise that as soon as a shred of evidence appeared to suggest flossing isn't necessary, people were keen to toss the floss.
The theory behind flossing is simply the removal of bacteria, (plaque), from between the teeth. Plaque is a key component in both dental decay and gum diseases, so it seems obvious to assume that removing plaque by flossing will reduce the risk of developing these problems. Brushing alone doesn't reach those tricky areas, so without flossing the bacteria living there go untouched. However, when we look purely at the science, there is a lack of good quality, hard evidence to back this up when it comes to disease prevention.
The studies that have been done over the years show minimal differences between oral disease in people who floss and people who don't. Does this mean flossing doesn't work? Maybe. The key thing to take away from this review is that we need more evidence. The studies that do exist are either too short to be useful, too small to be useful, or rely on people using floss correctly - which can be hard to do. Flossing has the potential to have an impact on oral health, but it's not been proven beyond a doubt on a population level.
When it comes down to it, flossing is very low cost and low risk. You really have to be doing it very wrong to cause damage, and it's a skill that can be mastered with a little practice. This is why dentists recommend it: flossing is a very simple way to reduce plaque levels that has the potential to be beneficial. What we need is more evidence, and better quality evidence to really know if flossing is essential for good oral health.
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