[jaredklewis]

Doesn't empirically demonstrating the efficacy of flossing face all the same challenges as any other medical research?

Of course it is difficult to definitely prove whether or not vitamin C supplements reduce the duration of a cold. That doesn't mean that we should all just abandon empiricism and start gulping vitamins because it is "common sense."

What if someone's "common sense" leads them to believe that use of a an abrasive cleaning technique like flossing might damage their gums? I can think of any number of non-scientifically backed rationalizations one could use for or against flossing.

So, even if not-definitive, what research is there on whether flossing improves oral or overall health?

[thedentist1]

What I meant with that "common sense" sentence was basically this:

- It's irrelevant to know if flossing "improves" overall health...what is relevant is that it will not worsen it, and you are removing rotting stuff from your teeth, and worst case scenario you just waste 2-3 minutes and have a more pleasant breath..why overcomplicate things?

It doesn't worsen your health, it either does nothing or improve it, so it is reasonable to do it

Medical literature is full of these things: do you need people to prove it with several studies that it's good for you to go for a walk every day? Try to weight the cost-benefit of your actions...if the cost is small, the risk non-existant, and the potential benefit high, it's usually a good idea

[insickness]

> It doesn't worsen your health, it either does nothing or improve it, so it is reasonable to do it

There are thousands of wives tales and pseudoscience remedies I don't need to waste my time on. If not backed by actual science, this type of recommendation is no better than any of them.

[xenophonf]

Here's the latest info I found on PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30968949 - "Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries." As dental plaque is the primary cause [of tooth decay and gum disease], self-administered daily mechanical disruption and removal of plaque is important for oral health. Toothbrushing can remove supragingival plaque on the facial and lingual/palatal surfaces, but special devices (such as floss, brushes, sticks, and irrigators) are often recommended to reach into the interdental area... Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque, or both, more than toothbrushing alone. Interdental brushes may be more effective than floss. Available evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent. Outcomes were mostly measured in the short term and participants in most studies had a low level of baseline gingival inflammation. Overall, the evidence was low to very low-certainty, and the effect sizes observed may not be clinically important. Future trials should report participant periodontal status according to the new periodontal diseases classification, and last long enough to measure interproximal caries and periodontitis.

Basically, good current dental hygiene practice is to brush and floss like the experts tell you.

[insickness]

Interesting. I wonder why there aren't better studies on this, particularly when flossing is so widely recommended.