Is Flossing Helpful or Harmful?
You can count on hearing, ‘don’t forget to brush and floss’ during visits to the dentist, on oral health educational videos and on TV. You may wonder why and when this refrain took hold and the reasons your dentist and hygienist stress the importance of this home healthcare routine.
Surprising though it may be, the practice of flossing isn’t new. There is evidence that even prehistoric man had a mechanism to remove foods from between their teeth. And while it’s been over two hundred years since an American dentist first introduced packaged flossing to the public, the toothpick was the #1 choice to remove those stubborn particles until the end of WW II. While the first flosses were made out of a silk thread, typically today’s floss is made from waxed or non-waxed nylon.
Why does the dental profession stress flossing along with brushing?
The majority of oral healthcare professionals began advising patients to floss for health reasons, not merely to remove a lodged popcorn kernel or a piece of lettuce from between our teeth. After years of research, dentists were provided scientific data to better understand the causes of decay, gum inflammation, periodontal disease, and bone loss. As our oral healthcare knowledge base grew, products, such as floss, were introduced to help prevent or mitigate the causes of dental disease. This became increasingly important as more recent research studies provided additional evidence showing the correlation between oral health and diabetes, heart disease and even cancers. Maintaining one’s oral health not only puts a happy, healthy smile on your face but also serves to enhance your general wellbeing.
Where does floss fit in the discussion of oral health? Brushing is important. It helps clean the surfaces of our teeth, but a toothbrush, even an electric, does not fully reach in between the teeth – spaces where it’s easier for these bacterial colonies to coalesce. This is where flossing comes into play. Bacteria live in our mouths. And that’s okay. In fact, there are hundreds upon hundreds of strains of bacteria; and each individual’s oral bacterial makeup is different. Most strains of oral bacteria do not pose a problem. But there are types that do. Sugars and starches, even found in many healthier foods, pose problems. It’s those carbohydrates. There is a type of oral bacteria that enjoys carbs as much or more than we do. The problem is that this bacterial strain, as it feeds on these substances, produces lactic acid that is known to dissolve the enamel of your tooth’s surface – one of the primary causes of dental decay. Other strains, though not as prevalent, are known to impact the health of the bone tissue of the jaw. With all these bacteria, our goal is to educate you on the techniques available to help prevent the ‘bad’ bacteria from forming colonies of harmful sticky substances. Floss breaks up the soft and sticky bacterial plaque. When our saliva does not wash it away and brushing does not reach all surfaces, this substance will adhere to the tooth’s surface. Left undisturbed, the production of lactic acid from the colonies of bacteria dissolve the enamel of the tooth surface. The result? The potential for tooth decay. Also, when plaque is not removed, in combination with products found in our saliva, it calcifies. This hard substance, calculus, if not removed regularly, cause gum tissue inflammation – leading to periodontal disease and potential bone loss. It’s the combination of brushing and flossing that disrupts the bacteria, stops the formation of the sticky substances and helps prevent the damaging build up. A good thing!
Why the recent hype about: ‘no need to floss’ or ‘flossing is harmful to your health’?
If flossing does all this hard work for us, why the recent articles? We don’t always have a definitive study that says that if you do ‘A’ you will be assured that ‘B’ will occur. There is not, as yet, fully definitive evidence-based research showing that if you floss you will not get cavities. But we do know that it makes sense as it removes harmful substances and reduces the buildup of cavity-causing plaque. And there is evidence-based research findings that flossing is beneficial in reducing the risk of gum diseases (and hence potential bone loss), which is a good enough reason in itself to floss. Just ask Drs. Hochberg and Diora. After years of practicing, they along with the preponderance of dentists and hygienists, have observed that the patients who brush AND floss regularly, present with healthier gums and teeth. As Karen, one of our hygienists of over 25 years at Colony Square Dental Associates says, “From my observation, patients that do floss have healthier gum tissue in comparison to those who do not. Patients that do not floss typically have bleeding and inflamed gum tissue. Water flossers are also effective and can help aid in keeping your oral health up to par.” And, what about articles asking, Is flossing dangerous? There was a small study that was released earlier this year reporting that women using a popular waxed floss were found to have higher levels of a specific type of PFAS (a chemical used to coat the floss). After reviewing the study the American Dental Association (ADA) determined that the cause and effect finding was not conclusive – as this chemical is found in the air, the water and even fast food containers. While further study is certainly warranted, according to the ADA Statement: “Study Involving Dental Floss”, released on January 14, 2019:
“PTFE is often used in food and beverage, pharmaceutical, and cosmetic applications. The fact that the researchers were able to find the PTFE marker in several brands of floss does not mean that it is the source of the PFHxS in the women. Given that this was a retrospective study including self-reported use of products, there are likely many other differences between women who did and did not report having used the brand of floss mentioned. The ADA sees no cause for concern based on current evidence, and above all continues to encourage people to clean between their teeth daily with floss or other interdental cleaners as part of the ADA’s daily oral hygiene recommendations.
At Colony Square Dental Associates we still say, “May the Floss be with You!”
The jury may still be out on whether waxed floss actually contains this chemical. And if it does, it is yet to be determined whether the chemical is released from the floss and ingested or whether it poses a risk. But, this is not an excuse to stop flossing! You may wish to read more about this topic before continuing with your current brand of floss. We encourage you to do so. And feel free to discuss alternatives with Drs. Hochberg, Diora and our hygienists – Karen, Cheryl & Gina. There are various options to break up the buildup of harmful bacteria on and between the teeth and at the gum line. Some floss is manufactured without chemical coatings and, as Karen says, there are other interdental devices such as the WaterPik®. So, we stand by the same old, same old mantra: Brush – twice a day! And Floss – at least once a day!