Does flossing reduce cavities?

Shrunk · #1 by **Shrunk** » Dec 20, 2011 12:50 pm

It is assumed that removing plaque (a layer of bacteria in an organic matrix which forms on the teeth) will help prevent gum disease (gingivitis) and tooth decay (dental caries). Gum disease, which appears as red, bleeding gums, may eventually contribute to tooth loss. Untreated tooth decay may also result in tooth loss. Toothbrushing removes some plaque, but cannot reach in-between the teeth, where gum disease and tooth decay are common. This review looks at the added benefit of dental flossing, in people who brush their teeth regularly, for preventing gum disease and tooth decay.

Twelve trials were included in this review which reported data on two outcomes (dental plaque and gum disease). Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult.

http://onlinelibrary.wiley.com/doi/10.1 ... 2/abstract

Grace · #2 by **Grace** » Dec 21, 2011 3:43 am

I've got an idea: If you've been flossing all your life, stop flossing now and see what happens a year from now. I'll bet you'll have more cavities, less money, and poorer health.

Shrunk · #3 by **Shrunk** » Dec 21, 2011 11:38 am

Grace wrote:I've got an idea: If you've been flossing all your life, stop flossing now and see what happens a year from now. I'll bet you'll have more cavities, less money, and poorer health.

I'd bet that, too. However, that would just be based on a guess. What I'm surprised about is the fact that there is no firm scientific evidence on this.

Personally, I've always been an indifferent and inconsistent flosser. My experience actually confirms the findings of the Cochrane study. I always have a lot of bleeding when I see the dentist for an annual checkup and cleaning. But I've had only one cavity since childhood, and that wasn't between the teeth.

Nonetheless, over the past year I've become an (almost) daily flosser. The bleeding gums are reason enough for me.

nunnington · #4 by **nunnington** » Dec 21, 2011 11:47 am

The thing that transformed my oral hygiene, if that is the right word, are interdental brushes. They are very small, and are pushed through the gaps between teeth like flossing. But they are more abrasive, and I find them brilliant. They come in different sizes. I also floss, natch.

babel · #5 by **babel** » Dec 21, 2011 1:13 pm

That's not what I was told, nor what I was expecting...

Can't say I floss, nor that me not flossing has meant bleeding gums or bad oral hygiene. No cavities and virtually no bleeding gums. Dentist says I've been blessed with good teeth and the habbit of brushing twice a day. :mrgreen:

Grace · #6 by **Grace** » Dec 21, 2011 3:02 pm

If flossing doesn't work, why brush?

I see my dentist tomorrow, boy are we going to have fun with this.

Shrunk · #7 by **Shrunk** » Dec 21, 2011 6:12 pm

Grace wrote:If flossing doesn't work, why brush?

Because for that, there is evidence:

http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract

Don't get me wrong. I am not using this thread to suggest flossing should be abandoned. I mostly just find it interesting how something so simple could be widely accepted as conventional wisdom, yet without any strong scientific evidence behind it.

I see my dentist tomorrow, boy are we going to have fun with this.

Let us know what he/she says.

james1v · #8 by **james1v** » Dec 21, 2011 9:03 pm

I dont floss. I brush my teeth after breakfast, dinner and before i go out at night. I also use a good mouthwash at least once every other day. Me teef are OK for someone my age, look... :cheese:

Ironclad · #9 by **Ironclad** » Dec 21, 2011 11:06 pm

What I'd like to know, ask your dentist, is that tartar stuff actually or mostly kettle scale (lime scale?).

Lance · **#10** by **Lance** » Dec 22, 2011 1:08 am

Grace wrote:
I see my dentist tomorrow, boy are we going to have fun with this.

You must be very talented. Strangely, when my dentist is working on me, I find my ability to engage in conversation seems to disappear.

james1v · **#11** by **james1v** » Dec 22, 2011 1:28 am

Ironclad wrote:What I'd like to know, ask your dentist, is that tartar stuff actually or mostly kettle scale (lime scale?).

I wouldn't know about "lime scale". Being from Sheffield, we have good, heavenly water, that froths with only the merest hint of soap, shampoo or detergent. Others, buy our water, for sometimes £3.00 a bottle. We laugh our clean, well frothed arses off at them for doing so! (We bathe in gallons of it) for next to nowt!

Grace · **#12** by **Grace** » Dec 23, 2011 6:40 am

They laughed at the dental clinic when I told them a weak, unreliable trial was being kicked around a forum site on flossing:
" Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult."

Here's their response: "Well, we've been in the business of dentistry for years, and we can tell you there is a huge difference between people who floss, and people who don't floss." That's good enough for me. I know it is true too. When I don't floss for awhile, the crap I dig out from between my teeth STINKS! It's ROT, and if you don't get rid of it every day, it will ROT your teeth.

Spearthrower · **#13** by **Spearthrower** » Dec 23, 2011 3:00 pm

Grace wrote:They laughed at the dental clinic when I told them a weak, unreliable trial was being kicked around a forum site on flossing:
" Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult."

Here's their response: "Well, we've been in the business of dentistry for years, and we can tell you there is a huge difference between people who floss, and people who don't floss." That's good enough for me. I know it is true too. When I don't floss for awhile, the crap I dig out from between my teeth STINKS! It's ROT, and if you don't get rid of it every day, it will ROT your teeth.

That's actually just an argument from authority, Grace - and while I am not calling you a liar, we also don't have independent access to your dentist to check what he/she is answering to. Of course, dentists are assuredly an authority on dentistry I am not disputing that, but if they are not basing their conclusions on scientific evidence, but informal personal observations, then you'll understand why the OP and Shrunk's questions still stand as a valid inquiry.

Personally, I have never flossed. There's no crap between my teeth, and it doesn't stink. There's no rot, and my teeth aren't rotten. So this is where anecdotes gets us. Thus, a systematic trial is precisely the kind of thing to separate incomplete observations from repeatable experimentation.

Shrunk · **#14** by **Shrunk** » Dec 23, 2011 3:28 pm

Grace wrote:They laughed at the dental clinic when I told them a weak, unreliable trial was being kicked around a forum site on flossing:

Correction. The trial I quoted was not "weak and unreliable". It was a rigorous and systematic meta-analysis which demonstrated that the evidence supporting a link between flossing and reduction in caries was "weak and unreliable." There's a big difference.

Here's their response: "Well, we've been in the business of dentistry for years, and we can tell you there is a huge difference between people who floss, and people who don't floss." That's good enough for me. I know it is true too. When I don't floss for awhile, the crap I dig out from between my teeth STINKS! It's ROT, and if you don't get rid of it every day, it will ROT your teeth.

Like I said, I'm not recommending people stop flossing, and I intend to continue myself. But that doesn't change the fact that that decision is based on nothing more than anecdotes and clinical intuition, rather than rigorous scientific evidence. It just surprises me that the evidence is so weak for an intervention that is so widely recommended. Well, I guess it shouldn't surprise me. I've probably been guilty of the same thing myself.