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Study of Twins Confirms Benefits of Flossing

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Study of Twins Confirms Benefits of Flossing

Study of Twins Confirms Benefits of Flossing

September 11, 2006
By: Jean Johnson for Dental1

Let’s face it, flossing can be sloppy and not all that fun. Getting into every last crevice is time consuming. Reaching clear back to do the last molar can be especially taxing, and then there’s the floss itself that entwines around your fingers like it’s got a right to be there.

More, the chore can seem especially onerous when it comes at night and all you want to do is settle down with a good book. It’s so easy to forget that one’s teeth are like a fine set of custom jewelry and proper care needs to be taken if they are to last.
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Tips for better flossing:

  • Wrap the floss around the contours of the tooth to get all the plaque that collects in this area.
  • At the gum line gently slide the floss into the space between the tooth and the gum.
  • Since rough flossing can injure the gums, a firm but gentle approach is best.
  • Commercial floss holders can help those without good finger dexterity.
  • Flossing is a learned technique that gets easier with practice.
  • Gums may bleed some and be slightly sore if a person is just getting into the habit of flossing. If discomfort and bleeding persists, see your hygienist or dentist.
  • Most children can floss their own teeth properly by age 10. Many find a loop of floss easiest to manage. A 10 inch piece of floss tied together is helpful for them.

  • Perhaps that’s why in 2004 when Listerine ran an adding claiming the mouth rinse is “as effective as flossing in removing plague between teeth,” first a major national flap and then a lawsuit ensued.

    “I am very concerned about television commercials being run that advocate mouth rinse as a substitute for flossing,” said general dentist Arlen K. Leight, DDS in a letter to the American Dental Association (ADA). “This advertising campaign can only lead to a turnaround in oral health for the American population. I would recommend pressuring the company to stop such advertising or pull the ADA Seal of Acceptance from this product.”

    Leight’s thoughts were echoed by another general dentist in Evansville, Illinois, Bruce Raibley, D.D.S. who observed that “approval of Listerine as being as effective as flossing completely undermines everything we do as practicing dentists in the area of periodontics therapy.”

    For their part, the good folks that supported Listerine’s marketing campaign said they never intended it to be an either-or kind of thing. The studies upon which the advertisement was based, said Lori Kumar, PhD and vice president of Oral Care Research and Development at Pfizer Consumer Healthcare, merely “support the benefit of adding Listerine Antiseptic mouthwash to a daily oral care routine.”

    Indeed, in results that were sponsored by Pfizer and published in the Journal of the American Dental Association, the authors reiterate that they recommend using Listerine “as an adjunct to mechanical oral hygiene regimens… [and] do not wish to suggest that the mouth rinse should be used instead of dental floss or any other interproximal cleaning device.”

    Eventually the case was settled by a U.S. District Judge, Denny Chin, who wrote in his decision that “dentists and hygienists have been telling their patients for decades to floss daily. The benefits of flossing are real… [and] Pfizer’s implicit message that Listerine can replace flossing is false and misleading.”

    In the aftermath, the ad was pulled, and dentists and hygienists across the country went back to counseling their patients about the benefits of regular flossing.

    It is true, according to dental assistant Cindy Clifton of Vancouver, Washington, that seniors or others who find flossing difficult because of dexterity issues could benefit from even the slightest edge mouth rinses and water irrigation devices can provide. “Some patients report that their hands will cramp when they floss. I’ve heard that from those who are still in their 50s,” said Clifton. “So you can imagine how things can get increasing difficult for people as they age.” That said, Clifton says anyone in the dental field she knows would confirm without batting an eye that flossing is the way to go. “I try to get patients who have problems to try one of the commercial floss threaders that are on the market. They can really help once a person gets used to them.”

    Clearly flossing is what the new study of twins that was published in the Journal of Periodontology touts. Twins were ideal for the comparison since they tend to eat similar foods, have the same or close to the same health profiles, and share general living environments. In the study, 51 sets of twins from ages 12 to 21 were separated into two groups, one half just brushing twice daily while the other brushed and flossed on the same schedule. Both groups of twins were also instructed to brush their tongues to decrease bacterial buildup that can contribute to halitosis or bad breath.

    The issue with flossing is gum health, and those that do this manual cleaning tend to enjoy pink gingival (gum) tissue that does not bleed when brushed or otherwise poked and prodded. Thus, as they most likely expected, researchers in the recent study found that the combination of brushing and flossing resulted in decreased gingival bleeding by 38 percent after just two weeks of the prescribed oral hygiene regime.

    As far as the results on those who just brushed? Bingo. No upwards and onwards for them. Rather their incidence of bleeding gums increased modestly but significantly over the two week period of the study at the rate of 4 percent.

    “Gingival bleeding and halitosis is often the first sign of poor oral hygiene that may eventually lead to further periodontal problems,” said study lead Walter A. Bretz, D.D.S., PhD and professor in the Department of Cariology & Comprehensive Care in the New York University College of Dentistry. “A good way to prevent periodontal disease and tooth decay is through at-home oral hygiene care and routine dental visits.”

    Since both groups brushed their tongue, the study didn’t produce any comparative results on that score. Nonetheless, the take home message is that getting in the habit of brushing the tongue can go a considerable way toward ensuring that bad breath does not sneak up on a person. As Kenneth A. Krebs, D.D.S. and president of the American Academy of Periodontology maintains, bacteria that cause bad breath accumulate not only on the teeth and gums, but also on the tongue. Thus, good home hygiene programs give attention to this aspect of oral care as well.

    “Bad breath and bleeding gums can occur in people who routinely brush just their teeth and gums,” Krebs said. “Bleeding gums can be a sign of periodontal disease, and bad breath may be from certain bacteria that have built up in the mouth. People with bleeding gums or bad breath should ask their dentist or periodontist about their periodontal health.”

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