As a periodontist practicing in Scarborough, I say this to those who rejoiced at the recent Associated Press report that found little scientific evidence backing the effectiveness of flossing: You should definitely still floss.

More than 500 different types of bacteria can be found in dental plaque. And while brushing removes plaque from the surface of your teeth, it is the accretions between the teeth and along the gumline that can trigger the formation of a pathogenic biofilm.

Prolonged exposure to plaque buildup can incite an inflammatory response in the gums, one that often leads to gum (periodontal) disease. As it advances, periodontal disease can erode the bone and gum tissue supporting the teeth, leading to tooth loss.

A person can minimize his or her periodontal disease risk through regular oral health care habits, dental cleanings and by undergoing a yearly comprehensive periodontal evaluation, in which a periodontist assesses the health of a person’s teeth, gums and bone structure to determine gum disease risk. By doing these things, a person is doing his or her part to contribute to a life of healthy gums.

Here’s what we need to understand about the Associated Press report: A lack of high-quality evidence is not proof of ineffectiveness. Much of the literature cited in the AP’s report was poorly designed.

An ideal investigation of flossing’s impact on gum health – research that has not yet occurred, likely because of the considerable expense – would require thousands of participants and, because gum disease is one that progresses slowly, would need to occur over the course of at least 10 years.

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Until research like this is conducted, my fellow periodontists and I encourage Americans to floss on.

May the floss be with you!

Jeffrey A. Brackett, D.M.D.

periodontist; member, American Academy of Periodontology

Scarborough


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