How Does Flossing Benefit Your Oral Health?


Author: David G. Dickerhoff, DDS, MAGD, FOCOI

You would have to have been living in a cave for the last month to have missed the titillating coverage of most media outlets and social sites that reveled in the claim that the Associated Press reported on the lack of evidence that flossing is a benefit to oral health. The AP stated that the federal government in a dietary guideline report from the Department of Health and Human Services said that there was no connection between the use of floss and oral health care benefits. They dropped the recommendation of daily flossing from their dietary guidelines which prompted many news outlets and social sites to lambast the dental profession and product companies. We were apparently bilking the public by recommending superfluous and unnecessary procedures. The Fayetteville Observer reprinted on August 4th an article from Jeff Donn of the Associated Press, which was an outstanding article that presents the merits of the argument in a very concise manner. If you are reading this blog, I assume you will want my opinion on this topical issue. My response just might surprise you.

While I am not going to be a shield for the floss or a hard liner for my chosen profession, I feel that my time spent in evaluating dental health over the past thirty years gives me some insight into what works and what doesn’t work. While I routinely recommend flossing to my patients on a once a day basis, we can all acknowledge that many of our practice’s patients do not floss and still have excellent check-ups during their lifetime. Flossing also is not recommended in many cases of limited dexterity, anatomical limitations or where there are alternative methods of interproximal cleaning. For those patients that brag about not flossing throughout their entire lifetime while showing no evidence of dental decay or periodontal disease, I say, “Count your blessings”. I agree with the Associated Press article pointing out that the evidence for the benefits for flossing is sparse and non-conclusive. As I see my profession advancing rapidly in new technologies during my clinical career, I noticed that most research has been centered on topics advancing the art and science of dentistry through regenerative procedures and new technologies. In spite of that, I have also seen thousands of patients with excellent tooth brushing habits and good plaque control who still experience interproximal decay which perplexes them. Whether it is systemic disease, dietary habits, gastro-intestinal reflux, immunocompromise or iatrogenic dentistry, these patients have cultivated a specific microbial environment that predisposes them to dental decay.

So if you are amazingly healthy, with no at-risk factors, maybe you can get away without flossing. As far as I am concerned, I will continue to teach my patients safe and effective flossing techniques and hope that this clarion call for better research motivates the dental profession to present my patients the satisfactory evidence that flossing can be an effective part of maintaining a healthy oral environment.