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But then again brushing with fluoridated toothpaste is one of the few dental interventions with good evidence supporting it's effectiveness (unlike flossing for

But then again brushing with fluoridated toothpaste is one of the few dental interventions with good evidence supporting it's effectiveness (unlike flossing for instance).

vixen99 7y ago
For sure, as always that which seems obvious may not be the case. On the face of it though, awaiting a definitive result as to the benefits or not of flossing and neglecting to remove that gooey matrix of dextrans on and around your teeth which certainly provides a happy hunting ground for a diverse collection of bugs, is possibly not the best strategy. https://en.wikipedia.org/wiki/Dental_plaque https://en.wikipedia.org/wiki/Dental_plaque
mattmanser 7y ago
I find it hard to believe this sudden flurry of doubt about flossing, just based on my own experience. I have quite packed together teeth and find flossing very fiddly, so am very inconsistent with it. When I don't floss, after 3 or 4 months, my gums start to puff up and bleed when brushed. When I do floss at least once a week, they don't. It was especially obvious when I smoked, a few months after visiting the dentist/hygienist I would get bleeding from my gums, at times quite worrying amounts and one of the many reasons I gave up. However, after a few nights of flossing, it would always reduce significantly.
- bluGill 7y ago
  Yes, but that is all anecdotes. Nobody with any intelligence seriously believes flossing is useless, but we don't have science to prove it, and until we have science there is room for doubt. If you don't know any science it is reasonable to argue that a heavy object falls faster than a light one, but once you do some science it isn't reasonable. (it is also reasonable to argue the other way, but most people would laugh at your argument until science proves them wrong at which point they should change their stance)
  - mattmanser 7y ago
    Yes it was an anecdote, but perhaps I wasn't clear, my point is that almost anyone whose gums bleed can easily test the benefits of flossing. A much better analogy would be that people are starting to claim that farts might not smell as there's no scientific studies that conclusively say so. As dentists point out rather regularly since that meta-study came out, they can clearly tell who flosses and who doesn't. Puffy, bleeding gums? You don't floss. You didn't have to labour the point about science quite so rudely, I am fully aware of the philosophy of science, thanks. Perhaps puffy, bleeding gums are perfectly healthy, but that seems unlikely as they hurt and are unsightly. On the upside, we know an easy fix for them, flossing. Do you honestly think that everyone here, or in any dentist's surgery, is going to laugh at me for claiming that?
    - Gys 7y ago
      My anecdote: I floss very very rarely and still my gum never bleeds. So it might be helpful for you, but not for me (at least not for the preventing bleeding).
  - tcfunk 7y ago
    I don't think I follow. I believe we have the science to prove that having food stuck between your teeth is worse than not having food stuck between your teeth.
    - bluGill 7y ago
      Parts of the puzzle are not the whole thing. We have science that aluminium in the brain correlated to alzheimers, and aluminium cookware causes high level of aluminium in the brain - but further science can't find a connection with alzheimers and cookware. (Note, the above is the state of science as of 20 years ago, things may have changed)
  - magduf 7y ago
    >Nobody with any intelligence seriously believes flossing is useless Incorrect, I've seen articles lately saying that flossing is useless because "there's no evidence that it's helpful". Seriously. I've even read that some dentists don't recommend it now. It's pretty mind-boggling to me, but I have no reason to doubt mainstream journalism that makes these claims. Personally, I use an electric toothbrush, but that simply cannot get all the bits of food out from between my teeth, the way flossing does. How anyone can think leaving bits of food between your teeth all night is a good idea, I have no idea.
- astura 7y ago
  "There's no good evidence that flossing is effective for preventing dental carries and periodontal disease vs brushing alone" is not the same as "flossing is not effective for preventing dental carries and periodontal disease vs brushing alone." Just because evidence for something doesn't exist or is weak doesn't mean it doesn't work, it just means we haven't done the high quality randomized studies to prove it works. And I'm not sure we'll ever have that, since these sorts of studies are expensive and there's ethical issues with asking a control group to stop flossing for years. When done properly flossing is a very low risk intervention, is cheap, has a plausible mechanism of action, has anecdotal evidence for effectiveness, and makes you feel nice and clean afterwards. So you probably should still floss, even if there is no high quality evidence of effectiveness.
  - d0mine 7y ago
    There are whole countries where flossing is not a thing. Fluoridated water protects your teeth. The rest may be just culture.
    - stevesimmons 7y ago
      Fluoride protects teeth, not gums!
      - AstralStorm 7y ago
        Healthy teeth project gums, or rather, unhealthy teeth lead to gum problems in the long run.
        stevesimmons 7y ago
        ... and food stuck between teeth leads to gum problems in the short run!
    - dgacmu 7y ago
      Almost all cultures have some mechanism of cleaning larger food particles between teeth, particularly back teeth. But, more to the point -- absence of evidence is not evidence of absence: https://www.health.harvard.edu/blog/tossing-flossing-2016081710196 https://www.health.harvard.edu/blog/tossing-flossing-2016081...
- cr0sh 7y ago
  > When I don't floss, after 3 or 4 months, my gums start to puff up and bleed when brushed. When I do floss at least once a week, they don't. That's effectively the very beginning of "gum disease"; your brushing of your teeth probably keeps it in check otherwise, but if you didn't brush or floss - imagine where that could lead to. Smoking only makes the problems worse (IIRC, it makes the gums more sensitive to abrasion and tooth decay products). It's ultimately best to brush and floss regularly, particularly before going to bed, or directly after eating. I'd say if you had to do one or the other, before bed and in the morning regularly would be best. Something to keep in mind also is how you floss - you want the floss to go between your teeth, but don't let it "saw" into (and injure) your gums - think of it more like a toothpick. On top of all this, go see your dentist regularly if you can afford it. Every 6 months is fine. You can get x-rays and other diagnostics (there's one for oral cancer, among other things - talk to your dentist) that can help with your overall health. I honestly believe (anecdote) that going to your dentist regularly can be more beneficial for your overall health than going to the doctor. Though, on that last bit, I honestly don't understand why here in America they leave it up to the patient to schedule regular doctor visits. I even asked my doctor's office staff if they could re-schedule me 6 months or a year later, and they wouldn't do it ahead of time, just "call us in a year" - which of course I never did. I suck at such follow-ups, but I've gone regularly to the dentist every 6 months for the past 25+ years - because they always schedule the next 6-month follow-up for me before I leave the office. I don't understand why it's not done as a matter of course by regular family practice doctors (though they seem to do this - I think - for children; but at some point you "age out" - or more often, leave home out from under your parent's care).

But then again brushing with fluoridated toothpaste is one of the few dental interventions with good evidence supporting it's effectiveness (unlike flossing for instance).

vixen99 7y ago

For sure, as always that which seems obvious may not be the case. On the face of it though, awaiting a definitive result as to the benefits or not of flossing and neglecting to remove that gooey matrix of dextrans on and around your teeth which certainly provides a happy hunting ground for a diverse collection of bugs, is possibly not the best strategy. https://en.wikipedia.org/wiki/Dental_plaque https://en.wikipedia.org/wiki/Dental_plaque

mattmanser 7y ago

I find it hard to believe this sudden flurry of doubt about flossing, just based on my own experience. I have quite packed together teeth and find flossing very fiddly, so am very inconsistent with it. When I don't floss, after 3 or 4 months, my gums start to puff up and bleed when brushed. When I do floss at least once a week, they don't. It was especially obvious when I smoked, a few months after visiting the dentist/hygienist I would get bleeding from my gums, at times quite worrying amounts and one of the many reasons I gave up. However, after a few nights of flossing, it would always reduce significantly.

bluGill 7y ago
Yes, but that is all anecdotes. Nobody with any intelligence seriously believes flossing is useless, but we don't have science to prove it, and until we have science there is room for doubt. If you don't know any science it is reasonable to argue that a heavy object falls faster than a light one, but once you do some science it isn't reasonable. (it is also reasonable to argue the other way, but most people would laugh at your argument until science proves them wrong at which point they should change their stance)
- mattmanser 7y ago
  Yes it was an anecdote, but perhaps I wasn't clear, my point is that almost anyone whose gums bleed can easily test the benefits of flossing. A much better analogy would be that people are starting to claim that farts might not smell as there's no scientific studies that conclusively say so. As dentists point out rather regularly since that meta-study came out, they can clearly tell who flosses and who doesn't. Puffy, bleeding gums? You don't floss. You didn't have to labour the point about science quite so rudely, I am fully aware of the philosophy of science, thanks. Perhaps puffy, bleeding gums are perfectly healthy, but that seems unlikely as they hurt and are unsightly. On the upside, we know an easy fix for them, flossing. Do you honestly think that everyone here, or in any dentist's surgery, is going to laugh at me for claiming that?
  - Gys 7y ago
    My anecdote: I floss very very rarely and still my gum never bleeds. So it might be helpful for you, but not for me (at least not for the preventing bleeding).
- tcfunk 7y ago
  I don't think I follow. I believe we have the science to prove that having food stuck between your teeth is worse than not having food stuck between your teeth.
  - bluGill 7y ago
    Parts of the puzzle are not the whole thing. We have science that aluminium in the brain correlated to alzheimers, and aluminium cookware causes high level of aluminium in the brain - but further science can't find a connection with alzheimers and cookware. (Note, the above is the state of science as of 20 years ago, things may have changed)
- magduf 7y ago
  >Nobody with any intelligence seriously believes flossing is useless Incorrect, I've seen articles lately saying that flossing is useless because "there's no evidence that it's helpful". Seriously. I've even read that some dentists don't recommend it now. It's pretty mind-boggling to me, but I have no reason to doubt mainstream journalism that makes these claims. Personally, I use an electric toothbrush, but that simply cannot get all the bits of food out from between my teeth, the way flossing does. How anyone can think leaving bits of food between your teeth all night is a good idea, I have no idea.
astura 7y ago
"There's no good evidence that flossing is effective for preventing dental carries and periodontal disease vs brushing alone" is not the same as "flossing is not effective for preventing dental carries and periodontal disease vs brushing alone." Just because evidence for something doesn't exist or is weak doesn't mean it doesn't work, it just means we haven't done the high quality randomized studies to prove it works. And I'm not sure we'll ever have that, since these sorts of studies are expensive and there's ethical issues with asking a control group to stop flossing for years. When done properly flossing is a very low risk intervention, is cheap, has a plausible mechanism of action, has anecdotal evidence for effectiveness, and makes you feel nice and clean afterwards. So you probably should still floss, even if there is no high quality evidence of effectiveness.
- d0mine 7y ago
  There are whole countries where flossing is not a thing. Fluoridated water protects your teeth. The rest may be just culture.
  - stevesimmons 7y ago
    Fluoride protects teeth, not gums!
    - AstralStorm 7y ago
      Healthy teeth project gums, or rather, unhealthy teeth lead to gum problems in the long run.
      - stevesimmons 7y ago
        ... and food stuck between teeth leads to gum problems in the short run!
  - dgacmu 7y ago
    Almost all cultures have some mechanism of cleaning larger food particles between teeth, particularly back teeth. But, more to the point -- absence of evidence is not evidence of absence: https://www.health.harvard.edu/blog/tossing-flossing-2016081710196 https://www.health.harvard.edu/blog/tossing-flossing-2016081...
cr0sh 7y ago
> When I don't floss, after 3 or 4 months, my gums start to puff up and bleed when brushed. When I do floss at least once a week, they don't. That's effectively the very beginning of "gum disease"; your brushing of your teeth probably keeps it in check otherwise, but if you didn't brush or floss - imagine where that could lead to. Smoking only makes the problems worse (IIRC, it makes the gums more sensitive to abrasion and tooth decay products). It's ultimately best to brush and floss regularly, particularly before going to bed, or directly after eating. I'd say if you had to do one or the other, before bed and in the morning regularly would be best. Something to keep in mind also is how you floss - you want the floss to go between your teeth, but don't let it "saw" into (and injure) your gums - think of it more like a toothpick. On top of all this, go see your dentist regularly if you can afford it. Every 6 months is fine. You can get x-rays and other diagnostics (there's one for oral cancer, among other things - talk to your dentist) that can help with your overall health. I honestly believe (anecdote) that going to your dentist regularly can be more beneficial for your overall health than going to the doctor. Though, on that last bit, I honestly don't understand why here in America they leave it up to the patient to schedule regular doctor visits. I even asked my doctor's office staff if they could re-schedule me 6 months or a year later, and they wouldn't do it ahead of time, just "call us in a year" - which of course I never did. I suck at such follow-ups, but I've gone regularly to the dentist every 6 months for the past 25+ years - because they always schedule the next 6-month follow-up for me before I leave the office. I don't understand why it's not done as a matter of course by regular family practice doctors (though they seem to do this - I think - for children; but at some point you "age out" - or more often, leave home out from under your parent's care).