Is Flossing a Waste of Time or Does It Prevent Dental Decay?

Updated on April 8, 2018
Beth Eaglescliffe profile image

Science graduate and business advisor, health educator and author, Beth writes articles on a wide variety of subjects.

Flossing makes you feel different.
Flossing makes you feel different. | Source

The One-Minute Flossing Technique

Whenever I visit my dentist and oral hygienist they say the same thing. Regular flossing is essential for dental health. Brushing alone will not remove all the food debris and bacterial film build-up from your teeth. The message is repeated in the media and by professional dental organizations.

I try to be a good patient and watch carefully as my dentist demonstrates the simple flossing technique. It’s easy to learn and easy to complete; just one minute is all it takes, he says. Brush your teeth after eating, and complete the process by manipulating dental floss around the teeth to remove all traces of food. The straightforward steps are as follows.

How to Use Dental Floss
1. Brush your teeth first and then floss.
2. Take a piece of dental floss 12-15 inches long.
3. Wind the ends around your two index fingers, but not too tightly.
4. Manipulate the middle part of the floss between each tooth.
5. It should take less than a minute to complete both upper and lower teeth.
Just one minute of your time, twice a day can improve your dental health.

How to Floss Your Teeth

Prevention is the secret to a happy dental life and long term health.

Brushing is great but it doesn't remove all the bacterial film between your teeth.

Flossing is the key to complete what brushing starts.

— Dr. Carlos Meulener, (DMD, New Jersey, US)

Don’t Feel Guilty About Not Flossing

Until recently, dental associations, national health services, federal and state governments were all on message and spoke with one voice. Yet quietly and with very few people taking notice, the US government recently changed its recommendation about the need to floss teeth regularly.

In 2015, the Associated Press investigated what (if any) evidence there was to back the US government’s established recommendation for regular flossing. They made requests to the US Departments of Health and Human Services and Agriculture under the Freedom of Information Act. Their conclusion was withering. AP said that the evidence for flossing was "weak, very unreliable,” of "very low" quality, and carried "a moderate to large potential for bias."

The main problem was that the few studies that do exist on the effect of flossing on gum disease and dental caries are too small, or lasted for too short a period. For example, one study looked at just one use of dental floss in 25 people. Another study assessing patient compliance lasted only two weeks. The small sample sizes and absence of a control group give these studies insufficient scientific rigor. It is thus inappropriate to extrapolate the results and make deductions from them to apply to the entire population.

How often do you floss?

See results

US Dietary Guidelines for Americans

The US government issues Dietary Guidelines for Americans every five years. Within a few months of the Associated Press making its request for information, the new plan was issued. The recommendation about the benefits of flossing had disappeared. It seems the federal government has concluded there is insufficient scientific evidence to back the claim that flossing works.

The American Dental Association and the British Dental Association continue to recommend that using dental floss helps maintain good oral health. So, what should you do? Are there (unscientifically proven) benefits associated with flossing?

Is Flossing Your Teeth a Waste of Time?

To Floss or Not to Floss?

Even though there are no long-term studies to prove its effectiveness, the dental community remain convinced that flossing provides tangible benefits. For a start, there is the purely practical benefit of being able to remove that annoying piece of meat (or similar) stuck between your teeth. Then there is the effect it has on making you pay more attention to your dental hygiene. For example, if you notice bleeding when flossing, this will alert you to early signs of gum disease and encourage you to visit your dentist.

Many people find flossing difficult because they lack the manual dexterity to do it effectively. Most people need to be taught how to use dental floss properly and this can take time and patience to learn. Some, like me, are a little lazy and can’t be bothered to floss on a regular basis unless a visit to the hygienist or dentist is imminent.

On my last visit, my hygienist suggested I try a Pro-Sys interdental brush instead of floss. This has the advantage of being much easier to handle than the floss string. It’s a very tiny wire brush that is poked though the gaps between each tooth. I’m pleased with the results so far. It makes my teeth feel clean and fresh. Because the mini brush is so easy to use, I find I’m using it more often than I used dental floss.

The American Dental Association's (ADA) Recommendations

Top Tips For Preventing Tooth Decay
1. Brush twice a day with a fluoride toothpaste.
2. Clean between your teeth daily with floss or interdental cleaner.
3. Eat nutritious and balanced meals and limit snacking.
4. Check with your dentist about the use of supplemental fluoride, which strengthens your teeth.
5. Visit your dentist regularly for professional cleanings and oral examination.
Interdental tooth brushes are often recommended by dentists instead of dental floss.
Interdental tooth brushes are often recommended by dentists instead of dental floss. | Source

92% of adults have had dental caries in their permanent teeth.

26% of adults have untreated decay.

Adults have an average of 3.28 decayed or missing permanent teeth.

— US National Health and Nutrition Examination Survey, 1999–2004

What Causes Tooth Decay?

Tooth decay (the technical term is "dental caries") is caused by a few very specific bacteria. It’s normal for a healthy mouth to have thousands of “good” types bacteria in it. You won’t make your mouth into a sterile cavity, but you do need to act to prevent the “bad” bacteria harming your teeth. These include some Streptococcus and Lactobacillus species.

The “bad” bacteria make acid from food sugars left on the surface of your teeth after you have eaten. The acid erodes the hard enamel surface of your teeth. Underneath the protective enamel is soft dentin and sensitive nerve endings which together form your tooth structure. Once the enamel is broken, cavities form and other bacteria can enter the tooth and attack and destroy the nerve roots leading to painful toothache.

If the cavities are small they can be filled by your dentist with amalgam or a propriety white dental filler. This action will reseal the enamel coating and prevent further tooth decay. A regular dental check-up is essential to spot these small cavities and limit the damage done by bad bacteria. If left unchecked, small cavities will lead to nerve root damage with the eventual loss of the tooth.

Diagrammatic cross-section of a tooth showing how cavities damage the protective enamel.
Diagrammatic cross-section of a tooth showing how cavities damage the protective enamel. | Source

What are Cavities? What Causes Gum Disease?

Foods That Help Prevent Dental Caries (Tooth Decay)

1. Sugar-free Gum

All foods, if left on your teeth, have the potential to cause tooth decay. The key is to brush your teeth after every meal to ensure all sugars are removed. One of the worst culprits is snacking between meals. Each time you eat a sugary snack, the bad bacteria use the carbohydrate film on your teeth to make acid for the next 20 minutes. Chewing sugar-free gum can help alleviate this problem. They help stimulate saliva which helps to wash more of the sugar off your teeth and be swallowed.

2. Dairy Foods and Leafy Greens

You probably already know that calcium is good for children and their growing bones. It’s also good for both adults and children to help maintain strong and healthy teeth. Calcium can be found in dairy products like milk, yogurt and cheese. Leafy green vegetables such as broccoli and cabbage are also good sources of calcium. Other options include Brazil nuts, almonds and canned fish with bones.

3. High-Fiber Foods, Fruit and Vegetables

Eating five portions of fresh fruit and vegetables a day is good for your general health and well-being. Good dental health is another reason to have plenty of these high-fiber foods in your diet.

Producing salvia has been mentioned a few times in this article as it is an essential part of keeping sugar deposits off your teeth and gums. Eating high-fiber foods keeps your saliva flowing around your mouth which helps defend against tooth decay. All fresh fruit and vegetables as well as dried fruit are good sources of fiber.

4. Whole Grains

Whole grains deserve a special mention because not only are they high in fiber, but they also provide B vitamins, iron and magnesium; all essential minerals for oral health. Whole grain foods such as brown rice and whole-grain cereals and pasta can easily be added to your diet. Use them instead of more refined versions and your teeth will benefit as a result of the improved nutritional input.

Children should be taught to care of their teeth from an early age.
Children should be taught to care of their teeth from an early age. | Source

Sources of Further Information

More information about maintaining good dental health can be found on the following websites.

The American Dental Association

The UK National Health Service (NHS)

The sources referred to in this article are given below.

“Medical Benefits of Dental Floss Unproven” Jeff Donn: Associated Press Aug 2 2016

The American Dental Association (ADA) advocates the use of floss alongside interdental brushes.

The UK National Health Service (NHS) recommends using interdental brushes as part of your daily oral health routine. They only recommend floss if the gap between your teeth is too narrow to use a brush.

Comments

Submit a Comment

  • profile image

    MsDora 13 months ago

    Very helpful. At first, I ignored the instructions to foll, but now that I'm older I have adopted the habit. It is true that flossing alone does not remove everything between the teeth.

  • Rosie Redfort profile image

    Rosie Redfort 13 months ago

    When flossing, I find that there are always little bits of food that come out on the floss. This might be because my teeth are particularly close together, but just thinking of the dental decay that this would cause, if not removed, is enough to make me floss every day! Interdental brushes are useful for getting bits of food out from nearer the gum line, but they can't be used between the top part of your teeth so flossing wins every time.

  • johnmariow profile image

    John Gentile 13 months ago from Connecticut

    I been flossing daily for years. Four years ago, an abscess appeared on my gums well above the teeth. I started flossing and using a mouthwash that fights gingivitis. I still have that abscess but it has not gotten worse.

    Many years ago when I wasn't flossing, the dentist found a large cavity at the gum line between my teeth near the back of my mouth. He told me flossing could have prevented that cavity from forming. Today I totally agree with him.

working