By now, you’ve probably seen or heard about the AP flossing report that claims the “medical benefits of dental flossing [are] unproven.” Needless to say, it has been causing quite a stir in Gentle Dentist offices! Not because it’s changing our opinions about oral hygiene – but because the article itself is a little misleading. Read the report here, then we’ll tell you what the dental community has to say, including a response from Andrea Edelen, a Registered Dental Hygienist and the National Director of Hygiene at Mortenson Dental Partners.
A lack of good research doesn’t prove something is ineffective.
As you’d imagine, a number of dental groups have already publicly shown their support for flossing since the AP report was released. The American Dental Association (ADA) and American Academy of Periodontology (AAP) were both quick to address the duration of these studies, which in general have been conducted only over short periods of time. In the AAP’s official statement about flossing, their president acknowledges that “much of the current evidence does not utilize a large sample size or examine gum health over a significant amount of time. Additionally, many of the existing studies do not measure true markers of periodontal health such as inflammation or clinical attachment loss.” And that “because the development of periodontal disease is slow in nature and because a variety of factors can impact its progression, studies that examine the efficacy of daily flossing are best conducted over a number of years and among a large population.”
What the studies in the AP report failed to incorporate in their research were very important factors, primarily family history and the presence of other health issues. One doctor even said he doubted the patients in the study flossed correctly. So although there may be conflicting conclusions about the efficacy of flossing, it’s worth remembering that flossing is only one aspect of maintaining good oral health. Just like maintaining a good diet is only one aspect of physical health.
The American Dental Association still defends flossing as an essential part of taking care of teeth and gums.
The AP report, despite all its claims that flossing is ineffective, still never fully endorses an end to flossing altogether. In fact, the report ends with a recommendation from Dr. Iafolla, a public health analyst at the National Institutes of Health: Office of Science Policy, to keep flossing once a day. “It’s low-risk, low-cost,” Dr. Iafolla said. “We know there’s a possibility that it works, so we feel comfortable telling people to go ahead and do it.” In an August 4 release, the ADA argues that the federal government has never changed its stance on flossing and “the Dietary Guidelines Advisory Committee (DGAC) made a deliberate decision to focus on food and nutrient intake (i.e., added sugar).”
“According to the American Dental Association (ADA), interdental cleaners such as floss are an essential part of taking care of your teeth and gums. Cleaning between teeth removes plaque that can lead to cavities or gum disease from the areas where a toothbrush can’t reach. Interdental cleaning is proven to help remove debris between teeth that can contribute to plaque buildup.”
Dental hygiene care plans should be personalized.
The official statement from the American Dental Hygienists Association (ADHA) endorses a dental hygiene care plan that is “personalized according to the individual’s unique oral health needs, general health status, values, expectations and abilities. Not all adjunct devices are appropriate for all patients, and it is important for dental hygiene professionals to work with their patients on which interdental cleaning method fits their needs.” For some patients, this could mean using a Waterpik®, or a water-flossing product that has been proven more effective than string floss at improving gum health. For others, like the dentist in the video above, the answer could be an old-fashioned wooden toothpick. Whatever decision you make, there is no better person to help you decide what’s right for you than the person who knows your teeth the best – your dental hygienist.
Now that you’ve heard how everyone else is responding, let’s hear what Andrea Edelen, a real-life Registered Dental Hygienist (RDH), has to say:
“We believe in dental hygiene practice that is both evidence-based and patient-centered. Our standard of care emphasizes that the oral hygiene recommendations be personalized according to the patient’s unique oral health needs, general health status, and abilities. Not all adjunct devices are appropriate for all patients, and it is important for dental professionals to work with their patients on which interdental cleaning method fits their needs. The ADA supports flossing with proper technique among other interdental cleaners being beneficial to removing bacteria, biofilm, and food debris from interproximal areas that a tooth brush cannot access.”