For years, dentists and hygienists have encouraged our patients to floss more. Meanwhile, this past August, an Associated Press report suggested that flossing is not necessary for good oral health. Who is right? Has flossing been a waste of time?
Thank you to The New York Times’ Jamie Holmes for publishing the article “Flossing and the Art of Scientific Investigation“. The article explains that while the Associated Press used 25 studies to draw the conclusion that brushing and flossing is not necessarily better than brushing alone, there are limitations to these studies.
In order to conduct a long term randomize controlled trial, we would need to ask people not to floss for three years. It is unlikely that such an experiment would pass an ethics board. (The article gives the example of parachute use – we have no clinical trials to determine that jumping out of an airplane is safer with a parachute vs without – it’s hard to find people to sign up for the control group.)
Even randomized controlled trials can lead to wrong conclusions. There are medications that pass medical trials and end up being removed from the market because of undesirable side effects.
While admittedly subjective, patients who start to floss on a regular basis will find their dental hygiene appointments much more pleasant. Dentists will also know from their clinical experience, also subjective, that flossing works. While scientific studies are valuable, experience and expert opinion also have value.
Flossing is good, as are parachutes.