To floss or not to floss?!

flossI couldn’t quite believe my eyes when I woke up on Wednesday morning to find my social media accounts had gone crazy over the breaking news that we no longer need to floss. The story had broken across all media outlets, everyone was talking about it!

I had a sinking feeling as I realised that all the hard work that I had put in to my patients oral hygiene over the past few years, including advice on routine flossing, would undoubtedly come under question and I could already envisage the deterioration in their gum condition as patients change their habits in reaction to the report.

These claims were made following an investigation by the Associated Press that looked into various studies that were carried out over the past decade comparing the benefits of toothbrushing and flossing versus toothbrushing alone. The evidence used to promote flossing was found to be weak and of poor quality. The individual studies were not carried out for any great length of time and using a small sample of people. As gum disease can take years to develop long term studies with large samples need to be conducted to gain reliable data in order to realise the true impact of flossing

I have personally seen many instances when the gum between the teeth is inflamed and bleeding (gingivitis) and it is evident that after the patient has been flossing that the inflammation has reduced. As gingivitis is a precursor to the more sinister second stage of gum disease – periodontitis, where teeth can be lost, I think it is important to try to do all we can to prevent it.

An important point to stress is that the findings are not stating that you should not floss, only that the evidence gathered about the benefits of flossing in these studies was insufficient.  Neither are they telling you that you shouldn’t clean the spaces between your teeth via alternative means and therefore this should still be an important part of your daily routine. Toothbrushing alone does not access all the surfaces of your teeth but the potentially harmful biofilm of bacteria knows as plaque does form on all these surfaces and therefore needs to be removed on a daily basis.

When the spaces are larger it is unlikely that you would be able to remove all the plaque and food debris from between the teeth with floss alone and it is then that alternatives such as interdental brushes are needed. There are many varieties on the market but two well known effective brands are TePe and Vision. These come in a variety of sizes and your dental clinician will be able to advise you on the correct size to use and cleaning technique

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