Dietary guidelines sent the wrong message about flossing

Dietary guidelines sent the wrong message about flossing

The Medicine Cabinet: Ask the Harvard Experts

By Robert Shmerling, M.D.

Q: I recently read that flossing may not be necessary. I have never met a dentist that said I don’t need to do it. What’s your medical opinion?

A: What you read was misleading!

Here’s what was in the news about flossing over the last few months:

The recently released Dietary Guidelines for Americans, 2015-2020, removed the recommendation found in previous versions that flossing regularly is among the most effective ways to reduce dental caries (cavities).

The reason given was that the guideline authors felt the benefits of flossing had not been adequately proven through high quality scientific research.

These new guidelines are now silent regarding dental health. Other measures, including “reducing the amount of time sugars and starches are in the mouth, drinking fluoridated water, and brushing,” have also been eliminated. Perhaps that makes sense because these are dietary guidelines, not recommendations about how to maintain oral health.

Unfortunately, many news outlets reported these developments as a reason to give up flossing or reported that flossing was no longer necessary. But that’s a misreading of the new guidelines. In fact, there has been no recent research or medical news suggesting that flossing is not an important and effective part of keeping your teeth and gums healthy.

There’s a saying in the research world that “absence of proof isn’t proof of absence.” That is, the absence of ideal evidence that an intervention is beneficial doesn’t prove it’s worthless. So, the fact that the new dietary guidelines removed recommendations about flossing is not a reason to stop flossing.

Like you, I’ve also never met a dentist who suggested flossing wasn’t a good idea. And that’s unlikely to change. When it comes to taking care of your oral health, my suggestion is that you listen to your dentist.

(Robert H. Shmerling, M.D., is Associate Professor of Medicine at Harvard Medical School and Clinical Chief of Rheumatology at Beth Israel Deaconess Medical Center in Boston.)