You gotta admit, it’s a headline just tempting you to click:

screenshot of Futurity headline

Trouble is, the study being reported on doesn’t actually tell you what that headline promises. What it does say is that, when it comes to preventing plaque-induced gum disease, some home hygiene practices are supported by more clinical studies than others.

Those that are supported by the most research? Toothbrushes, interdental brushes, water flossers, interdental brushes, essential oil rinses, chlorhexidine, and cetylpyridinium chloride (used in many conventional mouth rinses).

Of course, there are some who may see that and think, “Not flossing? Yay! I hate flossing.”

But “less evidence” isn’t the same as “no evidence.” In fact, the most recent Cochrane review on the matter (2019) found that

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.

More, the lead author of the “what works” study, Dr. Frank Scannapieco – chair and professor of oral biology at the University of Buffalo School of Dental Medicine – comes down in favor of flossing anyway, saying,

While there are few studies available that specifically examined toothbrushes or floss alone, both are still essential. Floss is especially useful to remove interdental plaque for people who have tight space between their teeth. Floss also likely reduces the risk for cavities that form between the teeth.

Does it matter if you floss before or after you brush? That’s actually the topic of a recent review in the International Journal of Dental Hygiene. It’s authors sifted through more than 9600 possibly relevant studies, drilling down to just two that met their criteria. Those two involved 60 patients total, primarily younger adults. What this limited research showed was that it really doesn’t matter all that much.

Flossing before or after brushing has no significant effect on reducing dental plaque index. However, more clinical studies should be conducted.

The important thing is flossing, period. After all, if you don’t clean between your teeth and at your gumline, you’re only cleaning about 60% of your total tooth surface. It’s like washing your hands without cleaning your fingers or bathing only from your head to your hips.

That said, there’s one great reason for flossing first: It can help ensure that you actually do it. It’s easy to “forget” to floss after brushing. Floss first, and chances are that you’ll do both, since flossing alone probably won’t leave your mouth feeling clean.

Just be sure you’re using the right technique when you floss. Doing otherwise can actually lead to some disastrous results, as we note in this earlier post

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