5 ms·

Time to toss the floss

45 points by CountHackulus 14y ago

shock 14y ago
Thank you for submitting this. I enjoy articles which challenge popular "wisdom" very much, especially those related to health. I hope one day we'll have a computer system to validate all of science's assumptions and when one of those assumptions turns out to be false by later research, to automatically correct conclusions drawn based on those assumptions.
famblycat 14y ago
The article says no studies show that flossing has any effect on tooth decay. But what about gingivitis? I know it's anecdotal, but since I started flossing regularly, I've noticed a drastic reduction in the amount of times I get inflamed gums.
- Dirlewanger 14y ago
  Exactly what I was thinking. Tooth decay's one thing, gum health is another, and wayyyy more important than teeth health (if we have to choose). Filling in cavities, applying new crowns, all relatively simple procedures these days. Replacing your gums? Yeah, that's probably going to require grafts from somewhere inside your mouth and will require seeing an oral surgeon if your dentist doesn't already do it. Overall, the experience won't be as..."simple" as a cavity filling.
  - pavel_lishin 14y ago
    > Overall, the experience won't be as..."simple" as a cavity filling. But they do give you date-rape drugs under incredibly monitored conditions, and then you wake up at home and spend a few weeks poking the stitches with your tongue! Floss your teeth, kids, and brush them regularly.
  - sharkweek 14y ago
    I absolutely hate flossing -- Telling my dentist this, he said that if I tried really hard to do it every so often (1-2 times a week to clean out anything really stuck), mouthwash will be more than sufficient at keeping my gums healthy.
- DanBC 14y ago
  Here's what the cochrane meta studies say: (http://summaries.cochrane.org/CD008829/flossing-to-reduce-gum-disease-and-tooth-decay http://summaries.cochrane.org/CD008829/flossing-to-reduce-gu...) > Twelve trials were included in this review which reported data on two outcomes (dental plaque and gum disease). Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult. (http://ohg.cochrane.org/cochrane-oral-health-group-scope http://ohg.cochrane.org/cochrane-oral-health-group-scope)
  - npsimons 14y ago
    Purely anecdotal, but I'm pretty sure I scrape some stuff off my teeth via flossing. In particular, there are areas near the rounded corners of my molars that, even after a good brushing, sometimes have stuff I can feel with my tongue. By looping the floss around as much of the tooth as possible and doing a few (not just one) up and down movements, it seems to get that stuff.
    - beagle3 14y ago
      But the question is, is that stuff bad for your gum or teeth health? That's not something you should assume a-priori. An analogy: Whenever you bath with soap, you remove a layer of oil off your skin - a layer that your body puts there to keep you moisturized and hydrated. If you bath and soap too often, your skin will suffer, not improve, even though you're "cleaning" your skin.
      - npsimons 14y ago
        True, but the stuff on my molars feels similar to the stuff on my incisors after skipping brushing for a few days.
nopal 14y ago
It's 404ing.
- CountHackulus 14y ago
  That's weird, it's a major Canadian newspaper.
  - randlet 14y ago
    Anecdotal, but I seem to run into more trouble with the Citizens URLS than any other paper I can recall.
    - heatherpayne 14y ago
      Even if you search for "floss", there are no results. The article has been taken down. Which seems weird... http://www.ottawacitizen.com/search/search.html?q=floss http://www.ottawacitizen.com/search/search.html?q=floss.
- rkowalick 14y ago
  Try http://www.readability.com/articles/ap1ukxbk http://www.readability.com/articles/ap1ukxbk
  - codva 14y ago
    That is also a 404
    - grayrest 14y ago
      use the 'Readability View' banner at the top for cached version.
- notirk 14y ago
  I can't find it on their site or Google News. Anyone happen to have another link?
- 14y ago
codva 14y ago
I read the article, then tried to go back to it to grab the URL to share. It's gone. The flossing conspiracy is apparently deep and quick to act!
commentzorro 14y ago
My dentist has repeatedly said flossing is for your gums, not your teeth.
- lobster_johnson 14y ago
  This is confirmed by my dental surgeon. (I had a minor graft to fix the receding gum above one of my canines.) Plaque is something you need to remove with the toothbrush, by massaging the area where the gum wraps around the teeth. On the other hand, my surgeon doesn't believe in mouthwash and says it's a waste of money.
golgo13 14y ago
I guess the corn in between 8 and 9 has a new home! In all seriousness, keep those gums healthy, folks.
mistercow 14y ago
This is fascinating. I had read before about xylitol's dental benefits, but I had not heard that they were so pronounced. I want to do some more independent research before I jump to any conclusions, but you can get pure xylitol pretty cheap online. It's a lot more expensive than sugar as a sweetener (~4x) and way more expensive than sucralose (~20x), but factor in dental bills and it starts looking downright cheap.
- berntb 14y ago
  Let me do some free advertising -- Jenkki professional chewing gum don't have any artificial sugars. They only have xylitol and some base. You can only buy it in Finland, not even in Sweden (grumble).
- meaty 14y ago
  Only problem is that xylitol gives you the shits. My dental hygiene routine which has worked well for 20 years is brush my teeth twice a day, avoid dentists altogether (most of what they do is unnecessary) and soft drinks and stay the hell away from non natural and refined sugars. I can munch ice cubes quite happily.
  - pinko 14y ago
    I do the opposite. I almost never brush (maybe once a month), but get my teeth cleaned twice a year religiously. Never had a cavity, (almost) never have bad breath. Normal diet. My guess is that the specific bacteria in your mouth make all the difference.
- verisimilitude 14y ago
  When you search on xylitol, use "futile cycle" in the query --essentially, bacteria take xylitol up because it looks enough like a genuine, useful sugar, but can't do anything metabolically useful with it. It would be like humans spending all our energy chewing wood.
  - npsimons 14y ago
    Interesting. Reminds me a bit of the parts in Greg Egan's "Permutation City" (fiction) where the protagonist is trying to force simulated bacteria to evolve to digest a "sugar" analogue that is poison. Hope our real world bacteria don't evolve to do anything useful with xylitol.
cshesse 14y ago
Google cache: http://webcache.googleusercontent.com/search?q=cache%3Ahttp%3A%2F%2Fwww.ottawacitizen.com%2Flife%2FTime%2Btoss%2Bfloss%2F7772029%2Fstory.html&oq=cache%3Ahttp%3A%2F%2Fwww.ottawacitizen.com%2Flife%2FTime%2Btoss%2Bfloss%2F7772029%2Fstory.html&aqs=chrome.0.57j58.1116&sugexp=chrome,mod=11&sourceid=chrome&ie=UTF-8 http://webcache.googleusercontent.com/search?q=cache%3Ahttp%...
- cshesse 14y ago
  Here is Dr Ellie's recommended cleaning method: http://www.drellie.com/pdfs/The-Kissing-System/Complete-Mouth-Care-System-Cliff-Notes-Version.pdf http://www.drellie.com/pdfs/The-Kissing-System/Complete-Mout...
  - Groxx 14y ago
    >Q: How often should I use Xylitol? A: 6.5 grams of Xylitol each day has been shown to eliminate harmful bacteria in about 5 weeks. ... And what other bacteria does it kill off? Since they're recommending it in pill form, it seems highly unlikely it's just affecting "bad" mouth bacteria.
    - pinko 14y ago
      This is an excellent question, and is the only reason why I haven't yet started using Xylitol.
    - FootballMuse 14y ago
      Xylitol pills? I'm pretty sure it recommends diluted crystals + gum/mints.
      - Groxx 14y ago
        Ah, true - they're just pill-looking. My mistake, thanks! I don't see 'diluted crystals' anywhere (the pre-brush rinse maybe?), but you are correct on gum / mints, so it's at least a lot more focused. Still - "consuming x grams" != "keep a ratio of X in mouth at least Y minutes per day". If consumption is what matters, how does it work?
kitcar 14y ago
This is syndicated from the Time of London: See http://www.thetimes.co.uk/tto/life/article3606527.ece http://www.thetimes.co.uk/tto/life/article3606527.ece here is a daily mail article with a similar thesis http://www.dailymail.co.uk/health/article-2237205/Is-flossing-teeth-waste-time--An-expert-says-theyve-got-wrong-.html http://www.dailymail.co.uk/health/article-2237205/Is-flossin...
- ricardobeat 14y ago
  And that's behind a paywall..
- webwanderings 14y ago
  Does the above Ottawa Citizen article seems like a plagiarized version of what is there at the Times UK? Lots of similarities.
tocomment 14y ago
So do I have to buy the book to learn the recommended procedure, or is it online somewhere?
- kaila 14y ago
  She has a pamphlet here with the procedure: http://issuu.com/zellies/docs/zellies-cmcsbooklet http://issuu.com/zellies/docs/zellies-cmcsbooklet And her website with more information here: http://www.drecoaching.com/ http://www.drecoaching.com/
thinkling 14y ago
Ah, toss the floss, not the FLOSS.
jongold 14y ago
But what will people use Lift for now?!
wissler 14y ago
Note: this article is about a substitute for flossing, not simply stopping flossing.
zeynalov 14y ago
I'm a dentist from Germany, University of Heidelberg. As I see, the author of the article has no idea what kind of benefits flossing has. She saw someone who didn't used floss and has good teeth. Yes, it's true that some people are more immune to the diseases than others. I saw a 65 year old women in Azerbaijan, who had never brushed her teeth and has 30 perfect teeth, without any paradontitis or tooth decay or any lost teeth. They were just perfect. Scientist found Mandibular Bones which were 600,000 years old, and they had all teeth on it. And we're sure that they didn't brush their teeth. - Homo Heidelbergensis ( http://upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Unterkiefer_von_Mauer_%28Replika%29.JPG/620px-Unterkiefer_von_Mauer_%28Replika%29.JPG http://upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Unt... ) So why some people don't get tooth decay or other diseases even if they don't brush their teeth? There are many factors, but for further read you can search Google. I'll answer the author of the article. She says that there are no studies showing if flossing is useful for tooth health. I wonder if she searched PubMed about that. There are hundreds of studies showing how benefical floss really is. (for ex.: http://www.ncbi.nlm.nih.gov/pubmed/22161438 http://www.ncbi.nlm.nih.gov/pubmed/22161438) I did several studies on myself and on my wife, about effects of floss. One most important advice that I can give people: Floss is as important as brushing.
- codva 14y ago
  From the PubMed link you provided. AUTHORS' CONCLUSIONS: There is some evidence from twelve studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone. There is weak, very unreliable evidence from 10 studies that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 and 3 months. No studies reported the effectiveness of flossing plus toothbrushing for preventing dental caries." That doesn't really support your case.
  - zeynalov 14y ago
    That's true, but this study shows some benefits of floss even it's weak. "Flossing plus toothbrushing showed a statistically significant benefit compared to toothbrushing in reducing gingivitis at the three time points studied, the SMD being -0.36 (95% CI -0.66 to -0.05) at 1 month, SMD -0.41 (95% CI -0.68 to -0.14) at 3 months and SMD -0.72 (95% CI -1.09 to -0.35) at 6 months." I just selected random study from the search results, didn't read it entirely. But there are hundreds of studies about benefits of floss.
JeffL 14y ago
The wikipedia info sounds a bit less promising than the claims made in the linked article: http://en.wikipedia.org/wiki/Xylitol#Dental_care http://en.wikipedia.org/wiki/Xylitol#Dental_care

45 points by CountHackulus 14y ago

shock 14y ago

Thank you for submitting this. I enjoy articles which challenge popular "wisdom" very much, especially those related to health. I hope one day we'll have a computer system to validate all of science's assumptions and when one of those assumptions turns out to be false by later research, to automatically correct conclusions drawn based on those assumptions.

famblycat 14y ago

The article says no studies show that flossing has any effect on tooth decay. But what about gingivitis? I know it's anecdotal, but since I started flossing regularly, I've noticed a drastic reduction in the amount of times I get inflamed gums.

Dirlewanger 14y ago
Exactly what I was thinking. Tooth decay's one thing, gum health is another, and wayyyy more important than teeth health (if we have to choose). Filling in cavities, applying new crowns, all relatively simple procedures these days. Replacing your gums? Yeah, that's probably going to require grafts from somewhere inside your mouth and will require seeing an oral surgeon if your dentist doesn't already do it. Overall, the experience won't be as..."simple" as a cavity filling.
- pavel_lishin 14y ago
  > Overall, the experience won't be as..."simple" as a cavity filling. But they do give you date-rape drugs under incredibly monitored conditions, and then you wake up at home and spend a few weeks poking the stitches with your tongue! Floss your teeth, kids, and brush them regularly.
- sharkweek 14y ago
  I absolutely hate flossing -- Telling my dentist this, he said that if I tried really hard to do it every so often (1-2 times a week to clean out anything really stuck), mouthwash will be more than sufficient at keeping my gums healthy.
DanBC 14y ago
Here's what the cochrane meta studies say: (http://summaries.cochrane.org/CD008829/flossing-to-reduce-gum-disease-and-tooth-decay http://summaries.cochrane.org/CD008829/flossing-to-reduce-gu...) > Twelve trials were included in this review which reported data on two outcomes (dental plaque and gum disease). Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult. (http://ohg.cochrane.org/cochrane-oral-health-group-scope http://ohg.cochrane.org/cochrane-oral-health-group-scope)
- npsimons 14y ago
  Purely anecdotal, but I'm pretty sure I scrape some stuff off my teeth via flossing. In particular, there are areas near the rounded corners of my molars that, even after a good brushing, sometimes have stuff I can feel with my tongue. By looping the floss around as much of the tooth as possible and doing a few (not just one) up and down movements, it seems to get that stuff.
  - beagle3 14y ago
    But the question is, is that stuff bad for your gum or teeth health? That's not something you should assume a-priori. An analogy: Whenever you bath with soap, you remove a layer of oil off your skin - a layer that your body puts there to keep you moisturized and hydrated. If you bath and soap too often, your skin will suffer, not improve, even though you're "cleaning" your skin.
    - npsimons 14y ago
      True, but the stuff on my molars feels similar to the stuff on my incisors after skipping brushing for a few days.

nopal 14y ago

It's 404ing.

CountHackulus 14y ago
That's weird, it's a major Canadian newspaper.
- randlet 14y ago
  Anecdotal, but I seem to run into more trouble with the Citizens URLS than any other paper I can recall.
  - heatherpayne 14y ago
    Even if you search for "floss", there are no results. The article has been taken down. Which seems weird... http://www.ottawacitizen.com/search/search.html?q=floss http://www.ottawacitizen.com/search/search.html?q=floss.
rkowalick 14y ago
Try http://www.readability.com/articles/ap1ukxbk http://www.readability.com/articles/ap1ukxbk
- codva 14y ago
  That is also a 404
  - grayrest 14y ago
    use the 'Readability View' banner at the top for cached version.
notirk 14y ago
I can't find it on their site or Google News. Anyone happen to have another link?
14y ago

codva 14y ago

I read the article, then tried to go back to it to grab the URL to share. It's gone. The flossing conspiracy is apparently deep and quick to act!

commentzorro 14y ago

My dentist has repeatedly said flossing is for your gums, not your teeth.

lobster_johnson 14y ago
This is confirmed by my dental surgeon. (I had a minor graft to fix the receding gum above one of my canines.) Plaque is something you need to remove with the toothbrush, by massaging the area where the gum wraps around the teeth. On the other hand, my surgeon doesn't believe in mouthwash and says it's a waste of money.

golgo13 14y ago

I guess the corn in between 8 and 9 has a new home! In all seriousness, keep those gums healthy, folks.

mistercow 14y ago

This is fascinating. I had read before about xylitol's dental benefits, but I had not heard that they were so pronounced. I want to do some more independent research before I jump to any conclusions, but you can get pure xylitol pretty cheap online. It's a lot more expensive than sugar as a sweetener (~4x) and way more expensive than sucralose (~20x), but factor in dental bills and it starts looking downright cheap.

berntb 14y ago
Let me do some free advertising -- Jenkki professional chewing gum don't have any artificial sugars. They only have xylitol and some base. You can only buy it in Finland, not even in Sweden (grumble).
meaty 14y ago
Only problem is that xylitol gives you the shits. My dental hygiene routine which has worked well for 20 years is brush my teeth twice a day, avoid dentists altogether (most of what they do is unnecessary) and soft drinks and stay the hell away from non natural and refined sugars. I can munch ice cubes quite happily.
- pinko 14y ago
  I do the opposite. I almost never brush (maybe once a month), but get my teeth cleaned twice a year religiously. Never had a cavity, (almost) never have bad breath. Normal diet. My guess is that the specific bacteria in your mouth make all the difference.
verisimilitude 14y ago
When you search on xylitol, use "futile cycle" in the query --essentially, bacteria take xylitol up because it looks enough like a genuine, useful sugar, but can't do anything metabolically useful with it. It would be like humans spending all our energy chewing wood.
- npsimons 14y ago
  Interesting. Reminds me a bit of the parts in Greg Egan's "Permutation City" (fiction) where the protagonist is trying to force simulated bacteria to evolve to digest a "sugar" analogue that is poison. Hope our real world bacteria don't evolve to do anything useful with xylitol.

cshesse 14y ago

Google cache: http://webcache.googleusercontent.com/search?q=cache%3Ahttp%3A%2F%2Fwww.ottawacitizen.com%2Flife%2FTime%2Btoss%2Bfloss%2F7772029%2Fstory.html&oq=cache%3Ahttp%3A%2F%2Fwww.ottawacitizen.com%2Flife%2FTime%2Btoss%2Bfloss%2F7772029%2Fstory.html&aqs=chrome.0.57j58.1116&sugexp=chrome,mod=11&sourceid=chrome&ie=UTF-8 http://webcache.googleusercontent.com/search?q=cache%3Ahttp%...

cshesse 14y ago
Here is Dr Ellie's recommended cleaning method: http://www.drellie.com/pdfs/The-Kissing-System/Complete-Mouth-Care-System-Cliff-Notes-Version.pdf http://www.drellie.com/pdfs/The-Kissing-System/Complete-Mout...
- Groxx 14y ago
  >Q: How often should I use Xylitol? A: 6.5 grams of Xylitol each day has been shown to eliminate harmful bacteria in about 5 weeks. ... And what other bacteria does it kill off? Since they're recommending it in pill form, it seems highly unlikely it's just affecting "bad" mouth bacteria.
  - pinko 14y ago
    This is an excellent question, and is the only reason why I haven't yet started using Xylitol.
  - FootballMuse 14y ago
    Xylitol pills? I'm pretty sure it recommends diluted crystals + gum/mints.
    - Groxx 14y ago
      Ah, true - they're just pill-looking. My mistake, thanks! I don't see 'diluted crystals' anywhere (the pre-brush rinse maybe?), but you are correct on gum / mints, so it's at least a lot more focused. Still - "consuming x grams" != "keep a ratio of X in mouth at least Y minutes per day". If consumption is what matters, how does it work?

kitcar 14y ago

This is syndicated from the Time of London: See http://www.thetimes.co.uk/tto/life/article3606527.ece http://www.thetimes.co.uk/tto/life/article3606527.ece here is a daily mail article with a similar thesis http://www.dailymail.co.uk/health/article-2237205/Is-flossing-teeth-waste-time--An-expert-says-theyve-got-wrong-.html http://www.dailymail.co.uk/health/article-2237205/Is-flossin...

ricardobeat 14y ago
And that's behind a paywall..
webwanderings 14y ago
Does the above Ottawa Citizen article seems like a plagiarized version of what is there at the Times UK? Lots of similarities.

tocomment 14y ago

So do I have to buy the book to learn the recommended procedure, or is it online somewhere?

kaila 14y ago
She has a pamphlet here with the procedure: http://issuu.com/zellies/docs/zellies-cmcsbooklet http://issuu.com/zellies/docs/zellies-cmcsbooklet And her website with more information here: http://www.drecoaching.com/ http://www.drecoaching.com/

thinkling 14y ago

Ah, toss the floss, not the FLOSS.

jongold 14y ago

But what will people use Lift for now?!

wissler 14y ago

Note: this article is about a substitute for flossing, not simply stopping flossing.

zeynalov 14y ago

I'm a dentist from Germany, University of Heidelberg. As I see, the author of the article has no idea what kind of benefits flossing has. She saw someone who didn't used floss and has good teeth. Yes, it's true that some people are more immune to the diseases than others. I saw a 65 year old women in Azerbaijan, who had never brushed her teeth and has 30 perfect teeth, without any paradontitis or tooth decay or any lost teeth. They were just perfect. Scientist found Mandibular Bones which were 600,000 years old, and they had all teeth on it. And we're sure that they didn't brush their teeth. - Homo Heidelbergensis ( http://upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Unterkiefer_von_Mauer_%28Replika%29.JPG/620px-Unterkiefer_von_Mauer_%28Replika%29.JPG http://upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Unt... ) So why some people don't get tooth decay or other diseases even if they don't brush their teeth? There are many factors, but for further read you can search Google. I'll answer the author of the article. She says that there are no studies showing if flossing is useful for tooth health. I wonder if she searched PubMed about that. There are hundreds of studies showing how benefical floss really is. (for ex.: http://www.ncbi.nlm.nih.gov/pubmed/22161438 http://www.ncbi.nlm.nih.gov/pubmed/22161438) I did several studies on myself and on my wife, about effects of floss. One most important advice that I can give people: Floss is as important as brushing.

codva 14y ago
From the PubMed link you provided. AUTHORS' CONCLUSIONS: There is some evidence from twelve studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone. There is weak, very unreliable evidence from 10 studies that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 and 3 months. No studies reported the effectiveness of flossing plus toothbrushing for preventing dental caries." That doesn't really support your case.
- zeynalov 14y ago
  That's true, but this study shows some benefits of floss even it's weak. "Flossing plus toothbrushing showed a statistically significant benefit compared to toothbrushing in reducing gingivitis at the three time points studied, the SMD being -0.36 (95% CI -0.66 to -0.05) at 1 month, SMD -0.41 (95% CI -0.68 to -0.14) at 3 months and SMD -0.72 (95% CI -1.09 to -0.35) at 6 months." I just selected random study from the search results, didn't read it entirely. But there are hundreds of studies about benefits of floss.

JeffL 14y ago

The wikipedia info sounds a bit less promising than the claims made in the linked article: http://en.wikipedia.org/wiki/Xylitol#Dental_care http://en.wikipedia.org/wiki/Xylitol#Dental_care