Category: Flossing

Shhhhh, DON’T TELL ANYONE: YOU DON’T REALLY HAVE TO FLOSS TO KEEP YOUR TEETH FROM FALLING OUT!

Posted on by Pinnacle Center - Dental Implants Periodontics

“What do you mean I don’t have to floss? I’ve been told that I have to floss every day or my teeth will fall out and I will never be able to get into dental heaven!”

Well, I don’t know if this will be good news or bad news for you. What you’ve been told is only partially true. I’m going to let you in on a dirty little secret. Floss is not a goal. Floss is a tool the way a screwdriver is a tool. The goal is to remove the film of bacterial deposits that we call plaque. Floss has a purpose just like screwdriver has a purpose. And, just like screwdriver is not the only tool in the toolbox …neither is floss. There are other tools that you can use.

“Plaque does not hurt so what’s the big deal if I have a little layer of nasty, filthy disgusting germs on my teeth? I can’t even see them so why worry about it?

You can’t see electricity either, but I’ll bet you won’t stick your tongue in a light socket because it will hurt you. Guess what? So will plaque/biofilm. When it piles up under the gum line and in between teeth it causes inflammation, infection, tooth rot and gum disease. If your gums bleed, then even brushing your teeth introduces the germs and the biofilm into your bloodstream. We have irrefutable scientific evidence that the germs from your mouth travel to your heart, your lungs and to your brain and cause issues like heart disease, low weight pre-term babies, erectile dysfunction and can even contribute to Alzheimer’s disease. If you have diabetes it makes your diabetes worse.

So, if that gets your attention then the next logical question you should ask is this:

“Since I hate to floss and, you say I don’t have to use it if I don’t want to, what else is there?”

Okay, I’ll say it again. Floss is not a goal it’s a tool. This is a tool that gets between the teeth since the toothbrush can’t clean between the teeth (even if you press real hard.)

The following is a list of other tools that can get in between teeth to remove the biofilm germ layer:

  • Stimudents
  • Rotopoints
  • Proxa-brushes
  • Opalpix
  • Gum soft pics
  • Water picks
  • Hydroflossers

Hate to floss? Shhhh. Don’t tell anyone I said, “You don’t have to floss to stay healthy.” You do however still have to clean between your teeth and you must remove the film of nasty little invisible bugs that cause damage and make you sick. You now have my full permission not to floss but you now have no excuse not to use another tool to keep yourself healthy. We will be happy to train you to use another tool and use it properly so that it gets the job done.

 

Remember, the decisions you make today will affect you for the rest of your life so make them carefully.

Flossing Doesn’t Work – Or Does It?

Posted on by Pinnacle Center - Dental Implants Periodontics

 

In Response To The Associated Press News:

Medical Benefits of Dental Floss Unproven

Yes, flossing works.
Yes, flossing works.

A few days ago, the Los Angeles Time picked up an article from the Associated Press entitled: “Haven’t flossed lately? Don’t feel too bad: Evidence for the benefits of flossing is ‘weak, very unreliable'” http://www.latimes.com/science/sciencenow/la-sci-floss-benefits-unproven-20160802-snap-story.html. As a dentist, periodontist, and health professional I felt compelled to write a response and share it here, on our blog, as well as via e-mail with patients and colleagues.

There is little “high quality” evidence for most of what’s done in medicine or dentistry.  Indeed, when “evidence based decision making” became a big deal starting in the late 1990s, many people twisted it to mean that a “lack of evidence” is somehow proof that the procedure in question doesn’t work.  Indeed, one sees this sort of misleading rhetoric all the time in other areas, especially in politics, sex and religion”.  And to be sure… there is plenty of politics in healthcare, sex and religion. The media thrives on misconstruing the facts and creating rhetoric.

That said, Tim Iafolla’s comments (from NIH) in the LA Times article are both troublesome and perplexing.  My guess is that he was quoted only in part — because even when there is very little evidence from what are considered to be weak studies, many procedures are recommended based on cost versus risk and in consideration of perceived benefits. It is fascinating how few “experts” seem to intuitively understand that every decision we make in life, from how we perform oral hygiene to changing lanes on the highway are most often considered in cost/benefit terms. Flossing studies? Who is going to pay for a study to follow 500 patients for 10 years? We learned in the 1960’s that a buildup of plaque bacteria, now called biofilms, causes bleeding gums and gum disease. We proved that removing said plaque allows the gums to heal. We have very strong medical evidence that inflammation anywhere in the body is bad and affects the entire system negatively. While some patients that are resistant to gum disease may not get much benefit from flossing, it helps many people quite a bit. And, truth be told, floss is not a goal it is a tool and other tools can be used besides floss to remove plaque. The idea is to remove the bacteria that cause infalmmation to a low level to prevent disease. This needs to be done between the teeth and floss is one tool that accomplishes that goal.

So yes, it is true, we don’t have high-quality evidence for flossing but that doesn’t mean it isn’t useful (just like we don’t have high-quality evidence that jumping off the US Steel Building is likely to be fatal).  And in light of the low costs of flossing and its potential benefits, is it not better to over-recommend flossing to reduce inflammation and disease than to under-recommend it?

But in a larger sense, this sort of near sighted thinking regarding evidence can easily spin out of control.  An LA Times author seeks to write a compelling article questioning and criticizing a long accepted practice. Kudos to him or her, that’s how one gets ahead in journalism-sometimes truth be damned.  But I can’t tell you how many times I hear otherwise smart folks condemn certain approaches in medicine, dentistry, life, etc. because supportive evidence is weak or not there at all.  Often this is done with a bit of ignorant intellectual arrogance that shouts: “I’m using evidence-based criteria here!”  Sorry Dr. knows it all… this is a fallacy that’s based on the all too frequent failure to only understand evidence-based decision making on the most superficial level.  Yet this foolishness seems increasingly widespread, all pivoting off the same and increasingly popular shallow thinking about what evidence (and lack of evidence) means and doesn’t mean.

So this is the most important thing to remember: A lack of high quality evidence is not proof that there is no benefit.  The lack of evidence does not prove that something does not work or is not effective. Thus, the lack of evidence only means that there is a lack of evidence.  And, because most of the time high-quality evidence has never been sought, the journalist that seeks to sensationalize and write a high profile story that garners national attention will get just that-a lot of attention even if the story is biased and untrue.

 

May The Floss Be With You

Dr. Mark Silberg