By Roy Benaroch, M.D., Emory University
In 2016, the Associated Press published a news story that hit the headlines all over the world. It highlighted flossing as a useless tooth cleaning ritual because there was no proof provided by scientific investigations regarding its usefulness. It made the Dietary Guidelines for Americans remove their recommendations for flossing in their guidelines. This announcement received mixed reaction from the press.
The Reactions Inside the US
In reference to the AP story about the absence of research about the efficacy of regular flossing, The New York Times reviewed two studies published in the Cochrane Review. According to this review, despite a lack of high-quality evidence, reduced gum bleeding was witnessed in people who brushed and flossed regularly. Also, there was some evidence that flossing contributed to reduced dental plaque.
They also quoted a dental professional that the effectiveness of flossing is limited due to improper flossing. Six trials were reviewed in which trained dental professionals flossed children’s teeth daily. It reduced the risk of cavities by 40%. So, we could conclude from this study that proper flossing is effective, although it was performed by professionals. But it doesn’t mean that flossing by ordinary people is totally ineffective and should be dropped.
CNN also published a report a day following the AP’s report. It investigated dental health in the big picture of overall health. The title of the story was Stopped Flossing? Teeth Still Vital to Overall Health and suggested that poor dental hygiene affects overall health and has costs for society.
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The Reactions Outside the US
The AP’s story received reactions on the international level, too. For example, the UK’s Telegraph reported that the country’s National Health Service would reevaluate their flossing guidelines based on that US report. The story then quoted the UK health secretary as “Now it turns out the only people really benefitting were the dental floss manufacturers. Yet another healthcare myth bites the dust.”
In Australia, the News Corps Australia Networks in a story headlined: Flossing is a Complete Waste of Time: Investigation stated that despite the dentists’ insistence on regular flossing, new studies suggest that flossing might do more harm than good. However, the story did not mention any adverse outcomes of flossing.
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In an official response to these reactions, the American Dental Association indicated that conducting a comprehensive study on flossing has some challenges. For example, people might not tell the truth about their flossing habits, or their flossing techniques might not be proper. They also stated that although there is no robust evidence regarding the effectiveness of flossing, it cannot be harmful and has a minimal cost. Also, the periodontal disease is so common that a solution like flossing with limited effectiveness can still be helpful for a lot of people. Then, they repeated that flossing is of high importance in the dental cleaning ritual.
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The Canadian Dental Association also followed the ADA and stated that an absence of sufficient evidence does not necessarily indicate that flossing is not helpful. It is just the result of the lack of optimal conditions to conduct studies on flossing the teeth.
Another website called the Dental Products Report also made a valuable point in this regard. The writer made an interesting comparison between the use of dental floss and another hygienic product, i.e., toilet paper. The article raises the question of whether for using toilet paper, we have to rely on the recommendations made by government agencies. The comparison goes on to ask if it is necessary to rely on thorough scientific investigations to carry on using toilet paper. Or, like dental floss, if toilet paper is not used correctly, will it lose its effectiveness? Based on common sense, toilet paper is useful, and people continue to use it no matter what.
Why Should we be Skeptic in Accepting Media News?
Regardless, we have to give AP credit for asking for proof to back flossing recommendations. Also, they were right about the weakness of the studies conducted. However, they had to take into account the contexts in which the studies were conducted and why providing substantial evidence was difficult.
There is a lesson for any skeptic in this flossing story: when there isn’t enough evidence about the usefulness of something, it doesn’t necessarily mean that it is not useful. In the absence of enough evidence for the effectiveness of flossing, we should not conclude that flossing is not practical.
Besides, different organizations, including government, private, or professional ones, recommend different things. Sometimes they do not have the same ideas about those recommendations. For example, the US government doesn’t recommend flossing anymore. But dental organizations around the world still recommend flossing. So, we should also see what party or body is making a recommendation and decide whether to accept it or not.
Common Questions about Media Reactions to a New Health Guideline about Flossing
Good dental hygiene includes a tooth cleaning ritual with brushing and flossing. Flossing is considered an essential step in preventing dental plaque.
Dental hygiene means keeping your teeth clean through flossing and brushing. It has effects on your overall health.
Yes. The American Dental Association recommends that you floss your teeth on a daily basis.
Daily flossing is recommended by the ADA as a part of the tooth-cleaning routine. However, incorrect flossing might harm the teeth.
