“To Floss or Not to Floss- Is this really the question we want to be asking?”

spinachteethIn August of 2016 a flurry of articles hit the media with respect to flossing. These articles pointed to several factors that seemingly made the case that flossing had not been proven effective.  For example:

  • The Associated Press reported that research into the long-term effectiveness of flossing had never occurred and therefore the efficacy of flossing could not be established;
  • Research into gum health as it related to regular flossing fell short because gum health was not measured ‘over a significant period of time’, ergo there was no way to measure the “real” (e.g. long-term) benefits of flossing on overall gum health, and;
  • Any evidence of the efficacy of flossing was limited, pointing to only a few scant Cochrane articles that anecdotally indicated that regular brushers and flossers had less incidence of gum bleeding than those who just brushed their teeth.

As a result of these articles, many on social and in mainstream media cheered the idea of being relieved of the perceived burden of flossing.

The Canadian Dental Hygienist Association weighed in on the controversy and stated that, “The Canadian Dental Hygienists Association (CDHA) recommends that more comprehensive research be undertaken to determine the effects of flossing on oral health before changes are made to established daily oral hygiene routines. Until then, dental hygienists will continue to recommend flossing and other interdental cleaning methods as part of an individualized plan for home oral health care.”

The CDHA approach is clear, while additional research may in fact be required to ascertain the full efficacy of flossing on oral health, dental hygienists will continue to promote and recommend flossing as part of a home oral health care routine.  Similar approaches and statements were made by American colleagues.  As dental hygienists the position of the profession is consistent, brush and floss as part of an oral care routine that is easy to maintain and inexpensive. As well, most oral health professionals will tell you that the clients they see who regularly floss have better gum health than their non-flossing counterparts.

So why even talk about this?  The fact remains that the media reported this story and it spread quickly amongst our clients, many of whom were seemingly looking for a reason to stop flossing.  Is it the cost? The time involved?  A rough estimate would put the cost of floss or flossing materials at about $30.00 annually and approximately 10 hours a year.  Are we making too much of proper flossing technique? Do we make it seem like a task that is too hard for the lay person to master?

Perhaps the real answer is about approaching oral care not only from an overall health and wellness point of view, but also from the point of view of something that our clients can resonate to more readily. Their needs and desires around oral health may be focused on the ‘outward’ or cosmetic aspects of oral hygiene.  Make no mistake, we should remind our clients of the role we play as dental hygienists in overall health and wellness.  This message is one we’ve fought hard to help our clients understand and of course we want to continue to share it, but cosmetic issues matter. We know they’re not the only issues, but they matter to our clients and that’s certainly fair enough.

To create a dialogue around the flossing issue we can ask our clients one fundamental question, doesn’t it feel good and look better to get food out from between your teeth?


One thought on ““To Floss or Not to Floss- Is this really the question we want to be asking?”

  1. I brought this topic forward as part of a study club discussion. It was a great opportunity to talk about how the media can impact our practice and the oral health of our clients. Headlines such a this grab the attention of dental professionals and clients. To be comprehensive in our care of clients, it is important that we not only read the headline, but take some time to research the statements. Thank you BCDHA for helping to identify the who, what, and why of the “to floss or not to floss” question. Upon review of this blog and after further investigation it is clear that the question is not whether to floss or not…but rather..where is the research that could tell us whether or not flossing as an independent factor could reduce the risks of dental disease. Thank you

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