Saturday, September 3, 2016

Getting Between Teeth Can Reduce Plaque Deposits and Gum Inflammation

"Dentists often suggest flossing as a highly effective way to avoid tooth loss and gum disease, but it appears many Americans choose to ignore that advice, reports U.S. News. According to a recent study, about 32% of adults in the U.S. never floss, and just over 37% admitted that while they do, they fall short of recommended daily cleaning."
Science Alert:
The US government has recommended flossing for nearly four decades. But according to the Dietary Guidelines for Americans, a set of recommendations the agency sends out every five years, all of the recommendations have to be grounded in scientific evidence.

And flossing is, well, not.

In its report, published Tuesday, the Associated Press says that it used the Freedom of Information Act to request evidence for the benefits of flossing from the departments of Health and Human Services.

AP never received that evidence. Instead, it got a letter from the government acknowledging that the effectiveness of flossing had never been studied. So the AP took a look at more than 25 studies comparing conventional brushing alone against brushing plus flossing. They found little to no evidence in favor of flossing.

That comes in sharp contrast to recommendations from basically every major dental hygiene organization, including the American Dental Association and the American Academy of Periodontology.

Many experts say that not flossing lets plaque, the thin film of bacteria that clings to teeth and builds up during the day, to become tartar, a hard deposit that can irritate gums. That tartar buildup can, in turn, cause the gums to recede. Worse, it could create a gap between the gum and the tooth, which could get infected and lead to gum disease.

Numerous reports have linked gum disease to a host of other diseases, including kidney disease, diabetes, and heart disease. Still, no research has concluded that one causes the other - only that there is some kind of relationship between the two.

A 2013 study in the journal CardioRenal Medicine, for example, found that people suffering from chronic kidney disease and gum disease were more likely to die of heart disease, a leading cause of death among those with kidney problems.

The study was unable to pinpoint the precise role gum disease might play in deaths from heart disease, but the researchers nonetheless recommended taking steps to cut back on gum disease in these patients.

People with diabetes have also been found to be at a higher risk of developing gum disease, and people with gum disease have similarly been found to be more likely to develop diabetes.

A 2012 study in the journal Diabetologia suggests that there is evidence supporting the existence of a two-way relationship between the two, but couldn’t ultimately conclude that that was the case

Floss can occasionally cause harm. Careless flossing can damage gums, teeth and dental work. Though frequency is unclear, floss can dislodge bad bacteria that invade the bloodstream and cause dangerous infections, especially in people with weak immunity, according to the medical literature.

National Institutes of Health dentist Tim Iafolla acknowledged that if the highest standards of science were applied in keeping with the flossing reviews of the past decade, "then it would be appropriate to drop the floss guidelines."

Regardless, he added, Americans should still floss.

"It's low risk, low cost," he said. "We know there's a possibility that it works, so we feel comfortable telling people to go ahead and do it."

ADA spokesperson Dr. Matthew Messina acknowledged the poor quality of the research supporting dental floss; however, he maintains that flossing is still an effective way to remove food from between the teeth.

“We need to remove bacteria from the teeth, from the gums, and from in between the teeth,” Messina told HuffPost. Messina went on to point out that there aren’t a lot of research dollars allocated for preventative measures that doctors already know are effective.

"Nowadays in the UK, we (I hope, how I hope) all recommend single-tufted interdental brushes as an adjunct to regular brushing. The studies prove beyond doubt that they significantly reduce plaque deposits, decreasing gum inflammation and reducing the risk of gum disease and bone loss."

More information:
» Associated Press: "Medical benefits of dental floss unproven"
» The Guardian: "Dentists have stopped being strung along by the great flossing yarn. About time"

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