Do I Really Need to Floss?

Since the summer, many patients have been asking me if they really need to floss.  No doubt encouraged by the many articles suggesting that flossing may not be necessary, I instantly broke the hearts of men and women when I highly encouraged my patients continue flossing.  I’m not a researcher, but I can tell you that, anecdotally, I can usually tell when my patients don’t floss or when they’ve been lax about it.  My coworkers have memorized what I tell patients about flossing: it’s like weight lifting; it hurts at first, but the more you do it, the stronger your gums get.  They know I tell my patients how I myself keep spools of floss scattered about my apartment to remind me to floss because I don’t like flossing either.

            But flossing your teeth is important because it helps remove food and plaque between teeth, where toothbrushes have difficulty reaching.  Floss also helps remove food trapped under the gums between these teeth as well.  So flossing, like brushing, helps break up the colonies of plaque that stick to your teeth.  Once this gunk, or biofilm, is removed, however, the bacterial colonies start to repopulate your teeth again, which is why my colleagues and I recommend you brush and floss your teeth daily. 

The recent mainstream articles seem to gloss over periodontitis.  Periodontitis is a disease affecting the gums and bone surrounding teeth.  Periodontitis can lead to infections and loss of teeth and its surrounding bone.  While flossing cannot cure periodontitis, it can help arrest the disease process at gingivitis, which is another reason I still encourage flossing.

While perhaps most of these studies are flawed, by design or execution, I want to make clear that the studies have not proven that flossing is not beneficial.  (Unless, of course, you are cutting into your gums with the floss; don’t do that!)   The Associated Press’s story contains links to the original studies if you’re interested in reading them.  Also worth mentioning is that the main review consulted in the AP’s article finds that flossing in conjunction with brushing is more effective in reducing gingivitis than brushing alone.  There has also been a study showing a decrease in cavities between teeth when professionals routinely flossed children’s teeth and administered fluoride, so maybe we just aren’t flossing effectively at home.