Recently there have been some headlines around suggesting you no longer need to floss. This comes as surprise to many people who floss regularly and many dental professionals who advise flossing. So where have these headlines come from and how much attention should we pay to them?
It is true that the evidence from research for flossing is weak. This does not necessarily mean that flossing is not beneficial, but may mean that the right studies have not been conducted in the right way to demonstrate the benefits. The aim of flossing is to remove plaque from between the teeth in an effort to prevent tooth decay and gum disease. It is quite clear that there is no way that normal toothbrush bristles can penetrate all the way between the back teeth which are broader and wider than the front teeth, so inevitably plaque will be left there after brushing. In my opinion, the best way to remove this plaque is with interdental brushes, and if you look beyond the headlines, most of the recent articles acknowledge this. These brushes are like tiny bottle brushes that you insert between the teeth. When you remove the brush you can easily see the plaque that the brush has picked up and dragged out. It is my feeling that floss might move the plaque around a little but does not pick it up and remove it in the same way as these interdental brushes. However, some people prefer to floss, or find the gaps between the teeth too small for using interdental brushes. In that case I advise flossing before normal brushing. The aim in this case is to move the plaque out from between the teeth so it can be brushed away with the normal brush.
I am quite sure it is no coincidence that the majority of tooth decay and gum disease I diagnose and treat occurs between the back teeth where the tooth brush bristles cannot reach. I was quite concerned to see these headlines. Knowing that many people don't read beyond the headline, I and many other dentists are concerned that people may be misled into thinking that cleaning between the teeth is not important. This is not the case at all and all dentists I know feel strongly about the importance of cleaning between the teeth. So if you can, use interdental brushes once daily, and if not then it's still well worth flossing before brushing.