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If you look up academic studies on flossing they nearly all say the same thing, it doesn’t prevent cavities more than brushing and the studies normally end with

If you look up academic studies on flossing they nearly all say the same thing, it doesn’t prevent cavities more than brushing and the studies normally end with “well flossing isn’t hurting anything so might as well keep doing it”. Flossing only helps with gingivitis in which case mouth rinses perform better. In the studies that do show flossing helps against cavities they are about professional flossing and not self flossing. So dentists continue to push unfounded claims regarding flossing.

Horffupolde 3y ago
It doesn’t prevent cavities by itself but it’s a great addition to good oral hygiene.
SECProto 3y ago
If brush my teeth, then I floss, bits of food still come out from between my teeth (they're quite tightly spaced). I don't need an academic study to confirm whether or not the flossing is helpful (unless you're disputing the causal link between food residue and tooth decay)
- iterateoften 3y ago
  Im not disputing anything other than when directly compared flossing does not prevent gingivitis, plaque or cavities better than a combined brushing and mouth rinse with regular professional cleanings. Flossing is generally associated with better oral health overall because if you take the time to floss you probably do a better job brushing as well. The burden is on the flossers to prove the efficacy beyond a secondary link and prove flossing is better in a controlled study. reality doesnt always match what they “feel” it should be.
  - SECProto 3y ago
    > The burden is on the flossers to prove the efficacy beyond a secondary link and prove flossing is better in a controlled study No, you're missing my point - the secondary link is the study of flossing w.r.t. oral health outcomes. The primary (causal) links are whether flossing removes food particles, and whether food particles cause tooth decay (neither of which seems to be under contention here). By just studying whether flossing improves oral hygiene, you're introducing a huge number of variables that are difficult to control for (flossing skill, other hygiene factors like flossing or "rinsing", dietary choices, self reporting errors, etc etc etc). (edit: to summarize: A causes B, B causes C, but you don't like saying A causes C because people kind of suck at A, and D, E, and F all also cause C which makes studying the relationship between A and C a challenge)
Aurornis 3y ago
> If you look up academic studies on flossing they nearly all say the same thing, it doesn’t prevent cavities more than brushing and the studies normally end with “well flossing isn’t hurting anything so might as well keep doing it”. That’s actually a misrepresentation of the studies. It gets pushed by journalists because contrarian “doctors are wrong” takes are very popular, especially when they tell people what they want to hear. The issue with flossing is that it’s hard to rigorously study over the duration needed to provide significant results. You also can’t really construct a study where you ask one cohort to not study for a couple decades to see if they do worse, because that has ethical concerns. So we’re left with self-reported flossing activity retrospectives. The problem with those is that people who floss tend to have better hygiene and self-care overall, so now we can’t isolate flossing as the reason for better dental health over a lifetime. > In the studies that do show flossing helps against cavities they are about professional flossing and not self flossing. This is an example of what I’m talking about: There are studies out there that show positive benefits of flossing, but if you find someone aggressively searching for reasons to discredit flossing then they’ll always find a reason to dismiss the evidence. When the goal becomes to be contrarian or to disprove something, you can always find a reason to dismiss the studies.
- iterateoften 3y ago
  It’s always important to ask why and look for the data yourself. Look at all the wives tales in the past that were semi-effective just because of placebo effects or like you say implementing a health measure (even if it is not directly effective) normally means you have better hygiene anyways. The problem with flossing is that it is so easy to do wrong which is why only professional flossing has significant effects. It’s worth people knowing that unless they are flossing on a professional level they aren’t necessarily doing anything to benefit themselves beyond what a mouth rinse would do.
  - xctr94 3y ago
    Mouth rinses often contain alcohol or other harsh substances, some of which have a correlation with mouth cancer. By comparison, flossing is comparatively harmless. You can floss wrong, but even that seems better than not flossing. From experience: I used to rinse AND floss, and the floss always came back with a little bit of organic matter which would’ve otherwise decomposed. So arguing against floss in praise of mouth rinses doesn’t seem like such an obvious ‘just do it’ idea. It’s probably more nuanced than that. And you can always use the wrong rinse or rinse incorrectly.
sunnybeetroot 3y ago
Flossing Is Associated with Improved Oral Health in Older Adults https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375740/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375740/
- iterateoften 3y ago
  That’s a self reported study and doesn’t control for the effectiveness of flossing. It’s generally accepted if you are flossing then generally you brush more often and more completely and in overall better mental and physical health than if you aren’t flossing because if you take the time to floss you are paying attention to your body. But controlled studies haven’t found floss to be effective as mouth rinses and brushing.
petercooper 3y ago
I don't get the criticisms about the effectiveness of flossing. I'm a regular flosser and get all sorts of stuff out from between my teeth that brushing doesn't. Without flossing, that stuff would surely just be stuck there for longer and causing bad breath and whatever else. Maybe other people's teeth aren't as tightly packed or something.
- iterateoften 3y ago
  It’s not a criticism of flossing but a criticism for health professionals recommending and putting so much trust in a health procedure that has very little proof it works.
speedylight 3y ago
Try to floss one of your molars a couple of hours after you eat and smell it a little bit, you'll be disgusted by what you discover.
- iterateoften 3y ago
  Ok, but that’s your feeling and that isn’t linked to any long term health of the mouth in controlled studies. If you brush and rinse, statistically it has a better effect than just brushing and flossing.
meristohm 3y ago
I need to floss (or use toothpicks; remember old timers picking their teeth eith wooden splinters?) to remove food bits stuck between my teeth. It's annoying, and if I leave it go for too long the chunk of celery/greens/whatever-fibers start to stink. I can't speak to flossing in general, just as a specific action that helps me feel better. I still get cavities despite brushing twice a day for two minutes each with fluoride toothpaste, waiting at least 20 minutes to brush after eating (especially after sugar or acids), and sleeping with my mouth closed (starting a few years ago after reading Breath by James Nestor- vertical surgical tape on my lips and sleeping on my back, took about 6 months before I could do it without the tape). I also stopped bruxating by relaxing my jaw every night before bed and, for the first few weeks of this, waking up frequently to make sure my mouth was still closed and my jaw relaxed.

Horffupolde 3y ago

It doesn’t prevent cavities by itself but it’s a great addition to good oral hygiene.

SECProto 3y ago

If brush my teeth, then I floss, bits of food still come out from between my teeth (they're quite tightly spaced). I don't need an academic study to confirm whether or not the flossing is helpful (unless you're disputing the causal link between food residue and tooth decay)

iterateoften 3y ago
Im not disputing anything other than when directly compared flossing does not prevent gingivitis, plaque or cavities better than a combined brushing and mouth rinse with regular professional cleanings. Flossing is generally associated with better oral health overall because if you take the time to floss you probably do a better job brushing as well. The burden is on the flossers to prove the efficacy beyond a secondary link and prove flossing is better in a controlled study. reality doesnt always match what they “feel” it should be.
- SECProto 3y ago
  > The burden is on the flossers to prove the efficacy beyond a secondary link and prove flossing is better in a controlled study No, you're missing my point - the secondary link is the study of flossing w.r.t. oral health outcomes. The primary (causal) links are whether flossing removes food particles, and whether food particles cause tooth decay (neither of which seems to be under contention here). By just studying whether flossing improves oral hygiene, you're introducing a huge number of variables that are difficult to control for (flossing skill, other hygiene factors like flossing or "rinsing", dietary choices, self reporting errors, etc etc etc). (edit: to summarize: A causes B, B causes C, but you don't like saying A causes C because people kind of suck at A, and D, E, and F all also cause C which makes studying the relationship between A and C a challenge)

Aurornis 3y ago

> If you look up academic studies on flossing they nearly all say the same thing, it doesn’t prevent cavities more than brushing and the studies normally end with “well flossing isn’t hurting anything so might as well keep doing it”. That’s actually a misrepresentation of the studies. It gets pushed by journalists because contrarian “doctors are wrong” takes are very popular, especially when they tell people what they want to hear. The issue with flossing is that it’s hard to rigorously study over the duration needed to provide significant results. You also can’t really construct a study where you ask one cohort to not study for a couple decades to see if they do worse, because that has ethical concerns. So we’re left with self-reported flossing activity retrospectives. The problem with those is that people who floss tend to have better hygiene and self-care overall, so now we can’t isolate flossing as the reason for better dental health over a lifetime. > In the studies that do show flossing helps against cavities they are about professional flossing and not self flossing. This is an example of what I’m talking about: There are studies out there that show positive benefits of flossing, but if you find someone aggressively searching for reasons to discredit flossing then they’ll always find a reason to dismiss the evidence. When the goal becomes to be contrarian or to disprove something, you can always find a reason to dismiss the studies.

iterateoften 3y ago
It’s always important to ask why and look for the data yourself. Look at all the wives tales in the past that were semi-effective just because of placebo effects or like you say implementing a health measure (even if it is not directly effective) normally means you have better hygiene anyways. The problem with flossing is that it is so easy to do wrong which is why only professional flossing has significant effects. It’s worth people knowing that unless they are flossing on a professional level they aren’t necessarily doing anything to benefit themselves beyond what a mouth rinse would do.
- xctr94 3y ago
  Mouth rinses often contain alcohol or other harsh substances, some of which have a correlation with mouth cancer. By comparison, flossing is comparatively harmless. You can floss wrong, but even that seems better than not flossing. From experience: I used to rinse AND floss, and the floss always came back with a little bit of organic matter which would’ve otherwise decomposed. So arguing against floss in praise of mouth rinses doesn’t seem like such an obvious ‘just do it’ idea. It’s probably more nuanced than that. And you can always use the wrong rinse or rinse incorrectly.

sunnybeetroot 3y ago

Flossing Is Associated with Improved Oral Health in Older Adults https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375740/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375740/

iterateoften 3y ago
That’s a self reported study and doesn’t control for the effectiveness of flossing. It’s generally accepted if you are flossing then generally you brush more often and more completely and in overall better mental and physical health than if you aren’t flossing because if you take the time to floss you are paying attention to your body. But controlled studies haven’t found floss to be effective as mouth rinses and brushing.

petercooper 3y ago

I don't get the criticisms about the effectiveness of flossing. I'm a regular flosser and get all sorts of stuff out from between my teeth that brushing doesn't. Without flossing, that stuff would surely just be stuck there for longer and causing bad breath and whatever else. Maybe other people's teeth aren't as tightly packed or something.

iterateoften 3y ago
It’s not a criticism of flossing but a criticism for health professionals recommending and putting so much trust in a health procedure that has very little proof it works.

speedylight 3y ago

Try to floss one of your molars a couple of hours after you eat and smell it a little bit, you'll be disgusted by what you discover.

iterateoften 3y ago
Ok, but that’s your feeling and that isn’t linked to any long term health of the mouth in controlled studies. If you brush and rinse, statistically it has a better effect than just brushing and flossing.

meristohm 3y ago

I need to floss (or use toothpicks; remember old timers picking their teeth eith wooden splinters?) to remove food bits stuck between my teeth. It's annoying, and if I leave it go for too long the chunk of celery/greens/whatever-fibers start to stink. I can't speak to flossing in general, just as a specific action that helps me feel better. I still get cavities despite brushing twice a day for two minutes each with fluoride toothpaste, waiting at least 20 minutes to brush after eating (especially after sugar or acids), and sleeping with my mouth closed (starting a few years ago after reading Breath by James Nestor- vertical surgical tape on my lips and sleeping on my back, took about 6 months before I could do it without the tape). I also stopped bruxating by relaxing my jaw every night before bed and, for the first few weeks of this, waking up frequently to make sure my mouth was still closed and my jaw relaxed.