7 ms·

Why You Should Never Skip Flossing Your Teeth

37 points by raymondduke 14y ago

mladenkovacevic 14y ago
Apparently, flossing also helps to prevent heart disease. Perhaps that's just some unfounded pseudo-science being pushed by the floss-manufacturers but in any case I imagine it can't be bad for you. Twice a day might be a little overkill, though.
- Ives 14y ago
  It's real science. Bacteria in your mouth can enter the bloodstream through wounds and travel to your heart. //EDIT: Apparently, although the association between gum disease and heart disease seems to be science, the causal link is not.
  - cma 14y ago
    What about wounds caused by flossing irregularly?
    - euroclydon 14y ago
      Seriously, and flossing undoubtedly pushes some food particles beneath the gum line.
  - run4yourlives 14y ago
    wut? You sure it isn't that people who floss tend to also be people that take better care of their bodies overall, and hence the two, while correlated, aren't an example of cause and effect.
    - Ives 14y ago
      Ehm, I'll admit that at this time no causal link is established although there is a correlation [1]. I've come to realize that I don't have a good source for what I wrote earlier. Sources like [2] do claim a causal link but I was unable to find the actualy study. [1] http://jama.jamanetwork.com/article.aspx?articleid=193088#qundefined http://jama.jamanetwork.com/article.aspx?articleid=193088#qu... [2] http://abcnews.go.com/Health/dental-screenings-linked-lower-heart-disease-stroke-risk/story?id=14936485 http://abcnews.go.com/Health/dental-screenings-linked-lower-...
      - run4yourlives 14y ago
        To be clear, I don't want to discount the studies completely, because there does seem to be a little bit of smoke there. That said any real conclusions are clearly premature for the data, as science reporting tends to be these days.
  - mylittlepony 14y ago
    Isn't that what the Lymphatic System is for? Bacteria do not simply enter the bloodstream, that would be a serious infection.
  - hackinthebochs 14y ago
    It's not about bacteria entering your bloodstream (if that happened you'd have bigger problems), its the inflammation caused by your body fighting the bacteria influencing other organs. Inflammation isn't an acute action, the signalling molecules involved travel around the entire body. This can cause inflammation in completely unrelated areas. The heart is highly susceptible to this since all your blood travels through it.
- msteinert 14y ago
  I believe the logic goes something like this: Research shows that perio disease may be linked to heart disease [1]. Flossing has been proven to reduce your chance of heart disease so it also reduces your chance of heart disease. I'm not going to try and dig up a bunch of studies to back this up. I drank the Kool-Aid years ago. It appears to have paid off for me in the dentists chair! [1]: http://www.perio.org/consumer/heart_disease http://www.perio.org/consumer/heart_disease
  - schoper 14y ago
    Correlation. Causation. Not the same. People who floss twice a day tend to have all sorts of good habits. In fact, they tend to be the sort of people who just plain "take care of themselves."
    - msteinert 14y ago
      Agreed! For the causation you'll have to read the extensive literature on periodontal disease.
      - run4yourlives 14y ago
        Which won't help much, given that the second line in your link is: While a cause-and-effect relationship has not yet been proven
        msteinert 14y ago
        Agreed, the cause and effect between heart disease and periodontal disease is not well proven. However, the beneficial effects of flossing in preventing periodontal disease is well understood and you're welcome to read the literature yourself if you don't believe me. I believe this is exactly what I said in my original comment.
gambiting 14y ago
What is this "flossing" he is talking about? Nobody I know flosses their teeth, is brushing and then using mouthwash twice a day not enough? Also, having a public health care helps with the bills, I go for a check-up every year and never had any serious problems.
- nollidge 14y ago
  Where are you located? Every dentist in the U.S. will scold their patients for not flossing.
  - pygy_ 14y ago
    AFAIK, it is not promoted in Europe. We're encouraged to brush after each meal, though, using fluorinated toothpaste.
  - gambiting 14y ago
    I am from Poland, currently living in the UK. In neither of those countries people floss, and I have never had a dentist recommend it to me. Lots of people brush and use mouthwash instead.
- lawn 14y ago
  I had no idea what flossing was either before googling it (translates to 'tandtråd' in swedish). Basically it's a thin thread or similar you use to remove stuff from between your teeth, not easily accomplished while brushing. I believe moutwash will help as well. Incidentally I also went to the dentist lately and I rarely brush my teeth more than once per day and I never floss but they thought my teeth looked good. My girlfriend flosses and brushes her teeth like a madman but she did not get any compliments for her teeth. I think it simpy varies from person to person and it's a lot about what you eat and drink.
- mturmon 14y ago
  It's not so much about the bills, its about the gum disease that you can get if you don't remove plaque from your teeth. Gum disease can progress rather quickly, so your one-year time scale might not be frequent enough to catch it. I'm now on a first-name basis with my periodontist, and a couple of years ago, I didn't know what that was.
w0utert 14y ago
FTA: Just recently I decided that I would give myself another dental check up. I seemed to have forgotten my horse racing lesson because I was expecting to have perfect teeth, again. I didn’t. I was given a bill that would be the equivalent of buying a decent used car. Ugh. Could I have prevented this? Yes, I could have. If only I had been flossing my teeth two times a day, I would have had less problems. My personal anecdote: last time when I went to the dentist, for the first time in ~10 years, because a tiny bit of a tooth broke off while trying to strip a piece of wire with my mouth (yes I know that's bad), I expected my teeth to be in horrible shape. Dentist fixed my tooth and did a full check-up including X-rays, and as it turns out, my teeth where in near-perfect condition, no cavities or other bad spots, just some dental plaque that needed to be removed. I haven't flossed a single time in my 30+ years long life. Moral of the story: flossing probably has nothing to do with dental health, as long as you brush your teeth and don't eat a lot of sugar.
- hcayless 14y ago
  I'll see your anecdote and raise you one ;-). I never used to floss, and would regularly have cavities to deal with (pretty much every visit to the dentist). When I started flossing religiously that ceased. I've had one filling (and that for a tooth cracked when I accidentally bit down on something hard) in the last decade. For me, there's a pretty clear benefit to flossing. I imagine there's a lot of variation in its usefulness, depending on things like diet, mouth shape & size, what kinds of bacteria you host, etc.
- lucian1900 14y ago
  Actual moral is probably that some people have better teeth than others.
  - kposehn 14y ago
    I guess the molar of the story is clear.
    - raymondduke 14y ago
      Great comment!
teuobk 14y ago
Interestingly, there haven't been many (any?) studies looking at the efficacy of flossing for prevention of carries (cavities). What evidence is available suggests that flossing can reduce gingivitis (gum disease). Relevant Cochrane review: http://summaries.cochrane.org/CD008829/flossing-to-reduce-gum-disease-and-tooth-decay http://summaries.cochrane.org/CD008829/flossing-to-reduce-gu...
norswap 14y ago
In Europe (at least the parts I'm used to), many dentist don't even actively recommend flossing to their patients. Some do, but they're in a minority. The other will say it's good if you ask them, but won't try to get you to do it unless you have a specific affliction for which it is especially indicated.
- riffraff 14y ago
  adding (possibly) a couple datapoints, it's the same for my home country (italy) and where I live (hungary). Sometimes they suggest you floss, mostly they don't.
  - pygy_ 14y ago
    The same goes for France and Belgium.
jakejake 14y ago
My dentist gives me a guilt trip about flossing on every visit. I've always thought that was a bit odd because it would be in his best business interest for me to neglect my teeth.
- Avenger42 14y ago
  Maybe if more people floss their teeth, cleanings would go faster, allowing him to see more patients, partially making up for the scarcity of expensive dental procedures?
- T-hawk 14y ago
  He's a professional. He genuinely cares about your dental health. Most medical doctors enter the profession because they genuinely want to help people, not exploit them for bucks. And prevention is very often the best method of help. Compare him to the programmer who creates an extensible open framework, as opposed to the guy who throws together a dense hack that only he understands. The latter could be said to be acting more in his own interest, but the former is more dedicated to his profession and the greater good.
- drcube 14y ago
  When you neglect to care for your teeth, you probably neglect to have others care for them as well. I'll bet the dentists' best patients are the OCD types who brush and floss five times a day.
- tomjen3 14y ago
  Short term, yes. Longer term, not so much. As word gets around that he isn't a good dentist, he will have fewer customers.
- lgieron 14y ago
  You found it a bit odd that he's not cynical?
- j_s 14y ago
  Every time my dental hygienist asks whether or not I'm flossing regularly, I reply that if they can't already tell the answer by looking closely then there's no point in flossing!
tokenadult 14y ago
An HN thread from eighteen days ago on flossing and dental care in general http://news.ycombinator.com/item?id=5007968 http://news.ycombinator.com/item?id=5007968 accumulated a lot of interesting comments after I last checked it soon after it was posted. Going back to those comments now is food for thought as I read this thread. I'm trying out some of the ideas that come from the article that opened the previous thread, for example by changing which mouth rinse I use daily. I still floss daily, and have for years, and since I began doing that (in adult life), my dentists have generally reported that my teeth are now in better condition than they were before I started that habit.
epoxyhockey 14y ago
The article draws an analogy between flossing teeth regularly and staying on top of your game, in general. I'm not a fan of the analogy in this case, but the tl;dr is: don't rest on your laurels when you're #1 at something. Reference: http://idioms.thefreedictionary.com/rest+on+laurels http://idioms.thefreedictionary.com/rest+on+laurels
pclark 14y ago
I floss all the time because it feels amazing
mistercow 14y ago
While the current consensus among American dentists is that flossing helps prevent cavities, this (like what seems to be a frightening amount of what dentists believe about dentistry) is not actually founded on or backed up by scientific evidence. There is slightly stronger evidence that flossing helps against gingivitis (http://www.ncbi.nlm.nih.gov/pubmed/22161438 http://www.ncbi.nlm.nih.gov/pubmed/22161438). As for dentists handing you a bill that would pay for a used car? There's an easy fix for that: ignore most of what they tell you, and get things fixed if/when they hurt. When the dentist has you sign a consent form that says "dentistry is not an exact science", take heed.
dgunn 14y ago
Am I still on HN?
- riffraff 14y ago
  yes and not hellbanned AFAICT.
  - dgunn 14y ago
    Nope. Just your standard flossing tips on HN. Nothing out of the ordinary here...
stcredzero 14y ago
A coworker of mine from way back had a dentist who put it this way: It's simple. You just have to floss between the teeth you want to keep. Flossing twice a day? I thought I was awesome for once a day.
at-fates-hands 14y ago
I went through a bout with severe Periodontitis. Just in case: http://en.wikipedia.org/wiki/Periodontitis http://en.wikipedia.org/wiki/Periodontitis "Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth." My case was pretty severe. Mainly from drinking WAY too much pop and not brushing and flossing on a regular basis. It is true flossing helps your gums in a lot of ways and considering they're the main support structure for your teeth, you really should take care of them. And even if there isn't any scientific data showing dental care and other diseases aren't related, shouldn't you just error on the safe side anyways?
beagle3 14y ago
Nutrition has a significant role in teeth health that is completely ignored by dentists. Apparently, vitamin D and vitamin K2 can do more for you teeth than regular brushing, provided that you don't keep your mouth sugared for too long: see e.g. http://www.westonaprice.org/journal/journal-spring-2007 http://www.westonaprice.org/journal/journal-spring-2007 And a pre-emptive answer to all those who will say Weston Price was a quack: No, he wasn't. Ignore the soundbites, read his studies, and modern follow-ups.
bmurphy1976 14y ago
I hate flossing. My teeth are packed tightly together. Getting the floss between them is tough so I tend not to do it I have to. I recently picked up a waterpik off of Amazon for about $40. It's essentially a water pressure based flossing system. I love it! It's easy to use and gets those spaces that are hard to reach with floss. If you struggle with flossing like me, I recommend taking a look. I've been very happy with the results so far.

37 points by raymondduke 14y ago

Apparently, flossing also helps to prevent heart disease. Perhaps that's just some unfounded pseudo-science being pushed by the floss-manufacturers but in any case I imagine it can't be bad for you. Twice a day might be a little overkill, though.

Ives 14y ago
It's real science. Bacteria in your mouth can enter the bloodstream through wounds and travel to your heart. //EDIT: Apparently, although the association between gum disease and heart disease seems to be science, the causal link is not.
- cma 14y ago
  What about wounds caused by flossing irregularly?
  - euroclydon 14y ago
    Seriously, and flossing undoubtedly pushes some food particles beneath the gum line.
- run4yourlives 14y ago
  wut? You sure it isn't that people who floss tend to also be people that take better care of their bodies overall, and hence the two, while correlated, aren't an example of cause and effect.
  - Ives 14y ago
    Ehm, I'll admit that at this time no causal link is established although there is a correlation [1]. I've come to realize that I don't have a good source for what I wrote earlier. Sources like [2] do claim a causal link but I was unable to find the actualy study. [1] http://jama.jamanetwork.com/article.aspx?articleid=193088#qundefined http://jama.jamanetwork.com/article.aspx?articleid=193088#qu... [2] http://abcnews.go.com/Health/dental-screenings-linked-lower-heart-disease-stroke-risk/story?id=14936485 http://abcnews.go.com/Health/dental-screenings-linked-lower-...
    - run4yourlives 14y ago
      To be clear, I don't want to discount the studies completely, because there does seem to be a little bit of smoke there. That said any real conclusions are clearly premature for the data, as science reporting tends to be these days.
- mylittlepony 14y ago
  Isn't that what the Lymphatic System is for? Bacteria do not simply enter the bloodstream, that would be a serious infection.
- hackinthebochs 14y ago
  It's not about bacteria entering your bloodstream (if that happened you'd have bigger problems), its the inflammation caused by your body fighting the bacteria influencing other organs. Inflammation isn't an acute action, the signalling molecules involved travel around the entire body. This can cause inflammation in completely unrelated areas. The heart is highly susceptible to this since all your blood travels through it.
msteinert 14y ago
I believe the logic goes something like this: Research shows that perio disease may be linked to heart disease [1]. Flossing has been proven to reduce your chance of heart disease so it also reduces your chance of heart disease. I'm not going to try and dig up a bunch of studies to back this up. I drank the Kool-Aid years ago. It appears to have paid off for me in the dentists chair! [1]: http://www.perio.org/consumer/heart_disease http://www.perio.org/consumer/heart_disease
- schoper 14y ago
  Correlation. Causation. Not the same. People who floss twice a day tend to have all sorts of good habits. In fact, they tend to be the sort of people who just plain "take care of themselves."
  - msteinert 14y ago
    Agreed! For the causation you'll have to read the extensive literature on periodontal disease.
    - run4yourlives 14y ago
      Which won't help much, given that the second line in your link is: While a cause-and-effect relationship has not yet been proven
      - msteinert 14y ago
        Agreed, the cause and effect between heart disease and periodontal disease is not well proven. However, the beneficial effects of flossing in preventing periodontal disease is well understood and you're welcome to read the literature yourself if you don't believe me. I believe this is exactly what I said in my original comment.

gambiting 14y ago

What is this "flossing" he is talking about? Nobody I know flosses their teeth, is brushing and then using mouthwash twice a day not enough? Also, having a public health care helps with the bills, I go for a check-up every year and never had any serious problems.

nollidge 14y ago
Where are you located? Every dentist in the U.S. will scold their patients for not flossing.
- pygy_ 14y ago
  AFAIK, it is not promoted in Europe. We're encouraged to brush after each meal, though, using fluorinated toothpaste.
- gambiting 14y ago
  I am from Poland, currently living in the UK. In neither of those countries people floss, and I have never had a dentist recommend it to me. Lots of people brush and use mouthwash instead.
lawn 14y ago
I had no idea what flossing was either before googling it (translates to 'tandtråd' in swedish). Basically it's a thin thread or similar you use to remove stuff from between your teeth, not easily accomplished while brushing. I believe moutwash will help as well. Incidentally I also went to the dentist lately and I rarely brush my teeth more than once per day and I never floss but they thought my teeth looked good. My girlfriend flosses and brushes her teeth like a madman but she did not get any compliments for her teeth. I think it simpy varies from person to person and it's a lot about what you eat and drink.
mturmon 14y ago
It's not so much about the bills, its about the gum disease that you can get if you don't remove plaque from your teeth. Gum disease can progress rather quickly, so your one-year time scale might not be frequent enough to catch it. I'm now on a first-name basis with my periodontist, and a couple of years ago, I didn't know what that was.

w0utert 14y ago

FTA: Just recently I decided that I would give myself another dental check up. I seemed to have forgotten my horse racing lesson because I was expecting to have perfect teeth, again. I didn’t. I was given a bill that would be the equivalent of buying a decent used car. Ugh. Could I have prevented this? Yes, I could have. If only I had been flossing my teeth two times a day, I would have had less problems. My personal anecdote: last time when I went to the dentist, for the first time in ~10 years, because a tiny bit of a tooth broke off while trying to strip a piece of wire with my mouth (yes I know that's bad), I expected my teeth to be in horrible shape. Dentist fixed my tooth and did a full check-up including X-rays, and as it turns out, my teeth where in near-perfect condition, no cavities or other bad spots, just some dental plaque that needed to be removed. I haven't flossed a single time in my 30+ years long life. Moral of the story: flossing probably has nothing to do with dental health, as long as you brush your teeth and don't eat a lot of sugar.

hcayless 14y ago
I'll see your anecdote and raise you one ;-). I never used to floss, and would regularly have cavities to deal with (pretty much every visit to the dentist). When I started flossing religiously that ceased. I've had one filling (and that for a tooth cracked when I accidentally bit down on something hard) in the last decade. For me, there's a pretty clear benefit to flossing. I imagine there's a lot of variation in its usefulness, depending on things like diet, mouth shape & size, what kinds of bacteria you host, etc.
lucian1900 14y ago
Actual moral is probably that some people have better teeth than others.
- kposehn 14y ago
  I guess the molar of the story is clear.
  - raymondduke 14y ago
    Great comment!

teuobk 14y ago

Interestingly, there haven't been many (any?) studies looking at the efficacy of flossing for prevention of carries (cavities). What evidence is available suggests that flossing can reduce gingivitis (gum disease). Relevant Cochrane review: http://summaries.cochrane.org/CD008829/flossing-to-reduce-gum-disease-and-tooth-decay http://summaries.cochrane.org/CD008829/flossing-to-reduce-gu...

norswap 14y ago

In Europe (at least the parts I'm used to), many dentist don't even actively recommend flossing to their patients. Some do, but they're in a minority. The other will say it's good if you ask them, but won't try to get you to do it unless you have a specific affliction for which it is especially indicated.

riffraff 14y ago
adding (possibly) a couple datapoints, it's the same for my home country (italy) and where I live (hungary). Sometimes they suggest you floss, mostly they don't.
- pygy_ 14y ago
  The same goes for France and Belgium.

jakejake 14y ago

My dentist gives me a guilt trip about flossing on every visit. I've always thought that was a bit odd because it would be in his best business interest for me to neglect my teeth.

Avenger42 14y ago
Maybe if more people floss their teeth, cleanings would go faster, allowing him to see more patients, partially making up for the scarcity of expensive dental procedures?
T-hawk 14y ago
He's a professional. He genuinely cares about your dental health. Most medical doctors enter the profession because they genuinely want to help people, not exploit them for bucks. And prevention is very often the best method of help. Compare him to the programmer who creates an extensible open framework, as opposed to the guy who throws together a dense hack that only he understands. The latter could be said to be acting more in his own interest, but the former is more dedicated to his profession and the greater good.
drcube 14y ago
When you neglect to care for your teeth, you probably neglect to have others care for them as well. I'll bet the dentists' best patients are the OCD types who brush and floss five times a day.
tomjen3 14y ago
Short term, yes. Longer term, not so much. As word gets around that he isn't a good dentist, he will have fewer customers.
lgieron 14y ago
You found it a bit odd that he's not cynical?
j_s 14y ago
Every time my dental hygienist asks whether or not I'm flossing regularly, I reply that if they can't already tell the answer by looking closely then there's no point in flossing!

tokenadult 14y ago

An HN thread from eighteen days ago on flossing and dental care in general http://news.ycombinator.com/item?id=5007968 http://news.ycombinator.com/item?id=5007968 accumulated a lot of interesting comments after I last checked it soon after it was posted. Going back to those comments now is food for thought as I read this thread. I'm trying out some of the ideas that come from the article that opened the previous thread, for example by changing which mouth rinse I use daily. I still floss daily, and have for years, and since I began doing that (in adult life), my dentists have generally reported that my teeth are now in better condition than they were before I started that habit.

epoxyhockey 14y ago

The article draws an analogy between flossing teeth regularly and staying on top of your game, in general. I'm not a fan of the analogy in this case, but the tl;dr is: don't rest on your laurels when you're #1 at something. Reference: http://idioms.thefreedictionary.com/rest+on+laurels http://idioms.thefreedictionary.com/rest+on+laurels

pclark 14y ago

I floss all the time because it feels amazing

mistercow 14y ago

While the current consensus among American dentists is that flossing helps prevent cavities, this (like what seems to be a frightening amount of what dentists believe about dentistry) is not actually founded on or backed up by scientific evidence. There is slightly stronger evidence that flossing helps against gingivitis (http://www.ncbi.nlm.nih.gov/pubmed/22161438 http://www.ncbi.nlm.nih.gov/pubmed/22161438). As for dentists handing you a bill that would pay for a used car? There's an easy fix for that: ignore most of what they tell you, and get things fixed if/when they hurt. When the dentist has you sign a consent form that says "dentistry is not an exact science", take heed.

dgunn 14y ago

Am I still on HN?

riffraff 14y ago
yes and not hellbanned AFAICT.
- dgunn 14y ago
  Nope. Just your standard flossing tips on HN. Nothing out of the ordinary here...

stcredzero 14y ago

A coworker of mine from way back had a dentist who put it this way: It's simple. You just have to floss between the teeth you want to keep. Flossing twice a day? I thought I was awesome for once a day.

at-fates-hands 14y ago

I went through a bout with severe Periodontitis. Just in case: http://en.wikipedia.org/wiki/Periodontitis http://en.wikipedia.org/wiki/Periodontitis "Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth." My case was pretty severe. Mainly from drinking WAY too much pop and not brushing and flossing on a regular basis. It is true flossing helps your gums in a lot of ways and considering they're the main support structure for your teeth, you really should take care of them. And even if there isn't any scientific data showing dental care and other diseases aren't related, shouldn't you just error on the safe side anyways?

beagle3 14y ago

Nutrition has a significant role in teeth health that is completely ignored by dentists. Apparently, vitamin D and vitamin K2 can do more for you teeth than regular brushing, provided that you don't keep your mouth sugared for too long: see e.g. http://www.westonaprice.org/journal/journal-spring-2007 http://www.westonaprice.org/journal/journal-spring-2007 And a pre-emptive answer to all those who will say Weston Price was a quack: No, he wasn't. Ignore the soundbites, read his studies, and modern follow-ups.

bmurphy1976 14y ago

I hate flossing. My teeth are packed tightly together. Getting the floss between them is tough so I tend not to do it I have to. I recently picked up a waterpik off of Amazon for about $40. It's essentially a water pressure based flossing system. I love it! It's easy to use and gets those spaces that are hard to reach with floss. If you struggle with flossing like me, I recommend taking a look. I've been very happy with the results so far.