As a periodontist in Mason City, I need to 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’s the plaque and debris that gather in the hard-to-reach spaces between the teeth and along the gum line that can be rather insidious if a person is not flossing regularly. Prolonged exposure to plaque buildup can incite an inflammatory response in the gums, one that often leads to gum disease (also known as periodontal disease). Periodontal disease can erode the bone and gum tissue supporting the teeth, leading to tooth loss. Research links it with systemic conditions as diabetes and heart disease.

According to the U.S. Centers for Disease Control and Prevention, one out of every two American adults over the age of 30 has some form of periodontal disease. A number of factors contribute to its onset, including age, whether a person smokes, the presence of other systemic conditions and family history. However, by flossing daily as part of a regular oral hygiene routine, a person is doing his or her part to contribute to 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 report was poorly designed. An ideal investigation of flossing’s impact on gum health — research that has not yet occurred, likely due to considerable expense — would require thousands of participants and, because gum disease progresses slowly, would need to occur over at least 10 years.

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

Dr. Gene J. Fortman, North Iowa Periodontics, PLLC


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