Over the years, it has generally been accepted that the use of dental floss has a positive effect because it removes more than 80% of the plaque. How do we know? You can use the so-called “mouth splitting” method, in which each person can act as his or her own control group, such as cleaning a thread with only a quarter of its mouth. Study participants were asked to stop brushing their lower jaw teeth, so that the plaque builds up; then I should to thread half and compare with the other half that will not thread.
After three weeks, cleaning with dental floss not only reduced the plaque by about 60%, but more importantly, reduced gingivitis symptoms by half – bleeding when checking the depth of the gum pocket and another index of gum inflammation. Note, however, that toothbrush cleaning here is nothing. People were not allowed to brush their teeth with a toothbrush. So yes, dental flossing is better than nothing but does the thread plus the toothbrush work better than just using a brush? Advocating for dental floss rests largely on common sense, but common sense does not go very far as a form of proof.
There’s no way to know … until we do the research. What is the effectiveness of dental floss in addition to brushing? Surprisingly, only 3 of the 11 studies that survey establish significant additional benefit. Those who deny the dental floss were certainly stunned, compared to the dentists they continued to protect scrubbing in the presence of human data supporting the claim that the Earth is flat. Dentistry is a profession in denial.
More than 80% of people do not brush their teeth regularly, and it’s just hard for the “dentistry elite” to accept that “The mass of people who do not use dental floss” is right, and we doctors are wrong. Toothbrush cleaning doesn’t work – get over it! You’ve heard of the tooth fairy. Is toothbrush cleaning just a fairy tale story? This review was published in 2008. More studies have since been published and while the evidence for further reduction of the plaque is weak, at least there is some evidence that it helps with gingivitis, which is the main reason we want to reduce the poster anyway.
Why haven’t they found stronger evidence? Well, the studies are of poor quality; therefore, the conclusions should be seen as unreliable. So, we don’t really have good evidence anyway, because good studies have really not been done. Why not? Why aren’t major dental floss companies funding research? Because all the dental floss seems to work the same way.
If you compare waxed dental floss with woven and tear resistant threads, they all have the same efficacy for removing the plaque, which seems to be established by all such studies So why a dental floss company would fund a study to show that flossing is useful if they cannot show that their product is better – otherwise you can just buy a dental floss from a competing company.
Where are we today? Although the technical evidence for dental floss is weak, more importantly, the methodology of the studies, who review the effectiveness of cleaning with dental floss is also weak. For example, they do not evaluate the quality of people’s teeth. This is not, for example, a way of cleaning with dental floss (don’t ask, long story). The conclusion is that the American Dental Association continues to recommend brushing and flossing every day. But what is the correct sequence?
When should you clean with thread? Before or after brushing your teeth? Some dentists say that threadblowing should come first, because that is how you mix the other particles and the plate, which can then be removed with a toothbrush, then the fluoride from the toothpaste can penetrate better. But other people recommend brushing their teeth first, thinking that this will remove most from food particles first and then cleaning with dental floss will be able to remove some of the fluoride from the remaining toothpaste. There’s no way to know … until we do the research.
The effect of the toothbrush sequence and then the thread To reduce plaque between the teeth and retain fluoride: a randomized controlled clinical trial and cleaning first with dental floss win in terms of removal significantly more plaque and more fluoride.
When we brush our teeth after we already brush with a toothbrush, many of the other particles that are removed with the thread, may remain on the teeth. The conclusion is that using a dental floss followed by brushing with a toothbrush is preferable.
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