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Why your dentist still wants you to floss your teeth

While you may jump at the opportunity to not floss after a recent Associated Press report,  as practicing dentists we urge you to keep flossing.

Headlines that flossing has no benefit were sparked after the recent omission of flossing in the newest Dietary Guidelines for Americans. While in the past these guidelines acknowledged the importance of flossing, they are not particularly focused on dental or oral health, but rather on dietary consumption and its health related factors.

Some of these reports have also linked to a 2011 Cochrane report, "Flossing for the management of periodontal diseases and dental caries in adults." This study attempted to assess past studies to determine the benefit of flossing in preventing periodontal diseases (i.e. gingivitis and periodontitis) and cavities.

The findings were that the existing studies were of poor quality and that flossing and brushing had very weak correlation with reduced amounts of plaque compared to brushing alone. While most readers will only want to focus on "little benefit compared to brushing alone," the first part of the sentence is of the most importance. The assessed studies were of poor quality, meaning that more studies need to be done, not that flossing is invaluable. The studies that were assessed only had a three-month duration, which is not enough time to determine whether flossing prevents periodontitis -- which can take years to develop. Nor did the studies last long enough to show benefits of preventing dental decay, which also can take longer than three months.

It is important to note that the American Dental Association, which is the leading source of oral health information, still recommends flossing once a day to remove plaque that toothbrushes cannot reach. It's easy to read what you want from a headline, but we challenge you to truly evaluate the reports and to floss on.

Dr. R. Craig Williams is a Periodontist-Prosthodontist and owner of Main Line Dental Group in Wayne, PA and has been practicing for 35 years. He is also a Clinical Associate Professor in the Department of Periodontics at the University of Pennsylvania School of Dental Medicine.  Dr. Courtney Lam is a graduate of University of Pennsylvania School of Dental Medicine and did postdoctoral training at the University of Oklahoma College of Dentistry.

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