Does Flossing Really Reduce Gum Disease and Cavities?

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Wellness Mama » Blog » Health » Does Flossing Really Reduce Gum Disease and Cavities?

For most of us, our parents ingrained the importance of brushing our teeth and flossing from a young age. Many of us feel guilty as adults for failing to do both every single day.

Flossing is one of the most common and accepted general health recommendations. It’s right up there with the importance of eating vegetables, drinking water, and getting regular exercise.

Yet, how many of us have actually researched the benefits of daily flossing?

Adults told us to do it from such a young age that we assume it’s beneficial to do it daily. But is it important?

I was a daily flosser for years upon the recommendation of my dentist, but since converting to more natural oral health options, I’ve wondered how important it is.

Flossing for Health Is Under Investigation

The internet is still abuzz with debate on the importance of this recommended daily practice after the 2016 publication of an AP News article called “Medical Benefits of Floss Unproven.”

Did you miss that one? Are you surprised?

After all, TV and the internet are still full of ads and articles promoting flossing for good oral health. You’ll still likely get a free sample of it the next time you go to a dentist.

Dental recommendations haven’t changed since this article came out.

Despite the sensationalist headline, that article didn’t conclude that flossing is necessarily bad, just that there may not be any scientifically-proven reason to do it.

Let’s look at the logic of this practice and then the actual research to see what science says about it.

The Logic of Flossing

At first glance, it seems to make perfect sense. Food gets stuck between teeth. Floss removes this food. Thus, this is a good daily habit.

While that may technically be true, taking care of your oral health isn’t quite so simple. After all, there’s also the issue of bacteria in the mouth, between the teeth, and in the gums.

Now, not all bacteria are bad. Some of it is actually protective—just like in your gut. But certain bacteria (referred to as pathogenic bacteria) contribute to cavities and gum disease. It is well documented that Streptococcus mutans is the main cause of dental decay. Various lactobacilli are associated with the progression of the lesion.

In other words, the Streptococcus mutans species of bacteria is associated with dental decay. Certain lactobacilli species contribute to making the cavity worse. Bad breath can be an indicator that your oral bacteria are out of balance.

Bacteria Lead to Cavities and Gum Disease

Dentists explain that cavities and gum disease occur in this way:

  • Plaque forms in the mouth when we eat sugars and fermentable carbohydrates.
  • The plaque creates acid, which leads to mineral loss on the surface of the tooth.
  • In a healthy mouth, the saliva will replenish the minerals on the teeth, and teeth will remain strong. This is also why diet is essential, as the body must have enough minerals to supply saliva.
  • If a person consumes sugars and simple carbohydrates regularly, the minerals on the tooth can’t be replenished each time. The plaque builds up and creates acid that maintains a low pH (acidic) environment in the mouth.
  • This creates an optimal environment for bacteria like S. mutans and allows them to take hold, eventually leading to cavities and gum disease.

Does It Help Reduce Bacteria in the Mouth?

This is an important question when it comes to flossing. If the acid > sugar > bacteria equation is the reason for cavities and gum disease, stopping these bacteria is very important for avoiding problems in the mouth.

But does it actually help?

According to dentist Reid Winick, DDS, it isn’t effective at removing this bacteria, and doing it daily may actually make things worse! He explains that it doesn’t affect these pathogenic bacteria in the mouth and that when they multiply, they can affect the body in many ways:

“If these pathogenic bacteria grow out of control and enter our bloodstream, they can be transported through the body and cause inflammation. Chronic inflammation of any source leads to chronic disease. Failing to take care of your teeth may set you up for a range of serious medical issues such as heart disease, diabetes, preterm birth delivery, Alzheimer’s, and even inflammatory cancers like breast and pancreatic cancer.”

But flossing won’t fix the problem. In fact, he argues that the idea is laughable:

“Don’t be fooled, flossing is not the answer! To me, it’s common sense. How can you kill an infection with a piece of string, especially if it can’t reach the bottom of the pocket where the infection lives?”

The Stats:

  • Approximately 98.4% of adults report to their dentist that they floss regularly when asked.
  • Approximately 60.5% of those people are lying.
  • Also, 68% of statistics on the internet are made up, at least according to Abraham Lincoln.

All joking aside, when you start looking at the research, the “well-documented” benefits don’t stand up to scrutiny. This doesn’t necessarily mean that it’s bad or not helpful, just that it deserves a closer look.

A Closer Look

The recent article that examines the evidence for flossing does so because the two most recent versions of Dietary Guidelines for Americans (2015-2020 and 2020-2025) make no mention of it. In the past, flossing has been part of their recommendations but was noticeably missing in the most recent updates.

So what happened?

The law requires experts to base these guidelines on well-documented scientific evidence. A few years ago, the Associated Press requested documentation from the Department of Health and Human Services and the Department of Agriculture about the benefits of flossing.

Instead of responding, the experts simply removed the recommendation from the guidelines for 2015-2020 and left it out again in the most recent one put out in 2020.

In other words, the government’s official health and nutrition publication, Dietary Guidelines for Americans, no longer recommends flossing.

The Research

The Associated Press examined the actual research. They looked at 25 studies that compared brushing alone or brushing and flossing and found that there was very little evidence for doing both—with a large potential for bias.

“The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal,” said one review conducted last year. Another 2015 review cites “inconsistent/weak evidence” for flossing and a “lack of efficacy.”

So, it doesn’t even necessarily remove plaque.

In fact, in recent years, several reviews have looked at the available research about flossing and attempted to determine if there was a benefit or not.

Recent Studies & Reviews

  • The first review looked primarily at children up to age 13. This review determined that children who had their teeth flossed by a trained dental hygienist at least five times a week noticed a 40% reduction in cavities and gum disease. Unfortunately, this reduction was not present in kids who did it on their own. Since most of us don’t have trained dental professionals to floss our teeth for us daily, the study concluded that its benefits were undocumented or limited at best.
  • The second review out of Amsterdam looked at available studies and determined: “In light of the results of this comprehensive literature search and critical analysis, it is concluded that a routine instruction to use floss is not supported by scientific evidence.”
  • The third and final review in recent years was the biggest to date: “Twelve studies, encompassing nearly 1,100 subjects were deemed suitable. Flossing was found to yield statistically significant reductions in levels of gingivitis and plaque buildup. However, the reductions were minuscule, almost to the point of being unnoticeable. And in regard to reducing plaque, the authors deemed the evidence to be “weak” and “very unreliable.”

So, what can we do to avoid these problems if flossing isn’t all that beneficial for reducing bacteria, cavities, or gum disease?

Other Ways to Reduce Bacteria

Thankfully, while flossing may not be as helpful as we once thought, it’s still useful in food removal. If you’re environmentally conscious, opt for the original natural silk version rather than the modern nylon version.

Beyond brushing and flossing, there are other ways to keep the mouth healthy. Aside from brushing with a good natural toothpaste and flossing with silk, you can try these alternatives:

Oil Pulling

This is one method I’ve been personally doing for years. Since adopting this practice, I have seen a definite reduction in plaque and tooth/gum sensitivity.

The name is a bit misleading, but it is essentially the process of using oil as a mouthwash. This post explains how to do oil pulling, but it involves swishing an oil such as sesame or coconut oil in the mouth for up to 20 minutes (sometimes with added essential oils).

This is beneficial because it reaches between teeth. The oil may help penetrate and break down the plaque. Additionally, oils like coconut oil can kill the S. mutans bacteria that lead to tooth decay. This makes oil pulling a great addition to your oral care routine.

Mouthwash

I’ve seen several dentists write articles suggesting mouthwash as an alternative since the AP article. They point out that mouthwash (like oil in oil pulling) can reach between teeth and the edges of the gums.

For this reason, mouthwash can reach bacteria that floss can’t. Companies design it to kill bacteria in the mouth. (Here’s my own herbal mouthwash recipe if you’re interested in making it yourself to maintain some of your mouth’s biome.)

To be clear, most dentists still recommend flossing but suggest adding mouthwash or another method, like interdental cleaners, to the mix as well.

Oral Irrigation

Oral Irrigation is another method that can help address bacteria in the gums and between teeth. My own dentists recommended it when I was younger and I used a Water Pik for years.

Like mouthwash, the idea is that the water can reach between teeth and into gums to address bacteria in the mouth.

Bottom Line: Does Flossing Matter?

While it may not be quite as important as we once thought, it’s still beneficial for food stuck between teeth. In light of the recent research, we can probably stop feeling guilty if we don’t floss every single day. Still, it’s a good idea to avoid food particle buildup leading to the growth of pathogenic (“bad”) bacteria and infections.

In that case, it’s good to be aware of proper techniques. If you’re not quite sure how to do it, here’s what the American Dental Association (ADA) recommends (it requires just a bit of dexterity):

  1. Break off about 18 inches of floss. Take it and wind it around one of your middle fingers. Do the same on your other hand.
  2. Hold the floss up tightly between your thumbs and index fingers.
  3. Gently glide the string between your teeth, but don’t snap it into your gums.
  4. When you get to the gum line, curve it into a C shape against one tooth. Slide it gently into the space between the gum and the tooth.
  5. Hold the floss tightly against the tooth and rub against the side of the tooth, moving it away from the gum. Use up and down motions. Repeat with the rest of your teeth, making sure to slide against all tooth surfaces.

It may also be a great idea to add oil pulling or mouthwash to address specifically pathogenic bacteria like S. mutans in the mouth.

How to Get The Right Type of Floss

The type you use matters. You don’t want to be putting petrochemicals and other toxins like Teflon, common in larger, well-known brands, into your delicate gum tissue. Remember, what goes on your skin and the inside of your mouth gets into your bloodstream.

For that reason, you’re not going to want to pick up regular floss from your local grocery store or drugstore. It’s important to know the ingredients that make up your dental products. After all, you’re putting them in your mouth!

If you’d like to add a completely natural, biodegradable dental floss to your daily oral hygiene routine, we’ve got you covered. Wellnesse now carries a silk floss that’s coated with natural candelilla wax (derived from a plant) and flavored with real antibacterial peppermint oil.

This article was medically reviewed by Dr. Steven Lin, who is a Board accredited dentist trained at the University of Sydney. With a background in biomedical science, he is a passionate whole-health advocate, focusing on the link between nutrition and dental health. As always, this is not personal medical advice and we recommend that you talk with your doctor or dentist.

Share with us! Are you a daily flosser? What do you think of this new information on dental health? 

Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

Comments

72 responses to “Does Flossing Really Reduce Gum Disease and Cavities?”

  1. Linc Jackson Avatar
    Linc Jackson

    Thank you for that article. Personally flossing was a failure because my gaps are so big that the floss just slips right by the food bits. I lost several teeth due to decay that was between the teeth and never seen until it was too late. I was flossing every day (no lie). With my dentist’s help I switched to minibrushes and I use those every morning and night. Going on 15 years and no new problems.

    Cool idea about the oil pull. I will try that.

  2. JC Avatar

    I wanted to weigh in here because I have gum disease. Mine was so bad that I was told I wouldn’t be able to keep my teeth. My brother had to have all his teeth pulled and implants put in, and we are relatively young. I am a plaque overproducer, this is genetic and can be determined by a test which was done on myself in my college microbiology class.

    I did my research and made some changes to combat my issue and its been 8 years or so and I only had to have one tooth pulled due to constant abscesses, and have kept all my others and my gums in good shape.

    When I first was informed of advanced gum disease I did a 3 month course of recommended antibiotics, and had a professional root planing and scaling. After that I have a scheduled periodontal cleaning every 3 months by my dental hygienist indefinitely.

    For home care I use a tooth flossing pic after every meal. I swish well with plain water before and after I brush which I do after every time I eat or drink any calorific beverages. I use a fluoride-free natural toothpaste, and I follow a Weston Price diet. I use a waterpik every night before bed and sometimes add clove oil or mouthwash to the waterpik water, and then I use an oral probiotic that utilizes (which were not mentioned in the article) which is used as a lozenge every night before bed that adds back beneficial bacteria (especially probiotic strain S. Salivarius) to the mouth while you sleep.

    I do not oil pull, I do not use mouthwash with alcohol in it undiluted, though I may use salt and/or essential oils in water if I have an mouth ulcer or tooth abscess.

    I used to get an mouth abscess every 2 or 3 months due to bacteria in the pockets around my gums proliferating. This was painful, upsetting and expensive. Now I can’t remember the last time I had one. I would not give up using the floss pic after every meal. I keep them at my desk and just use at my convenience. I use the floss side first between each tooth and then I use the pic side to push out anything that may be left between the teeth. Also important, -my hygienist informed me that I was making plaque overnight because I did not eat in the morning but she found soft plaque between my teeth, so I also floss first thing upon waking up to remove that overnight plaque.

    I can also not recommend enough swishing with plain water. 10 or so seconds *before and after* you brush is very helpful for getting into the pockets, the waterpik is even better! However I could not get away with using the waterpik once a week, I have to use it every evening before I brush to avoid abscesses.

    Science is great, but they can’t hit every side of the issue with the research, experience is always better. If you question whether something is useful and it is not dangerous, experiment to see what works for you. I hope that my experience helps someone.

  3. sarah Avatar

    The oral cavity is a contiguous part of the gut. Most “gut healthy” people have healthy oral cavities and less oral disease. Sadly, dentists have yet to equate the two and do not see this bigger picture. I think most of us reading this article fully understand how sugar & other toxins affect the healthy bacteria in your gut and will cause disease. It goes without saying that the oral cavity will be affected in the same way. An overpopulation of pathogenic bacteria in the gut (of which the mouth is a part of) prevents our bodies from doing what they are designed to do. The balance is off, and disease follows. As a retired RDH specializing in periodontal disease, I observed it on a daily basis. The quality of the food you eat determines the type of bacteria you have in your gut, thus affects the type of bacteria you have in your mouth. People with a population of healthy bacteria will typically have less gum disease and tooth decay over someone with a compromised gut.

  4. Su Avatar

    Hi Katie, this is my first comment on your website though I’ve been following you for years. Just wondering if you have looked into orthodontics and whether they are necessary? We use all natural oral health care but my 14yo daughter has very cramped teeth and growing at all angles. I’ve put off doing anything about it for years hoping that with our healthy diet and natural lifestyle they would sort themselves out naturally. It’s not looking like it atm and I want to look at what my options are now for her. I love your in-depth logical research into these things and would appreciate any thoughts you have about it. Thanks, Su

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