Should I bother to floss?

Facebook is fun. However it often can lead to some questionable advice being bandied about. For example, recently there have been several news feeds cluttering the airwaves propagating the claim that flossing is a waste of time. We saw people share this news freely, but very few bothered to dig beneath the headlines of this “fake news” to really get to the bottom of the article’s validity. Where was the science to support this claim?

The article was based on a report released by the associated press. The article investigated two previous reviews on the topic which essentially compared using a toothbrush alone VS using a toothbrush with dental flossing. It went on to posit that evidence for the efficacy of flossing was “weak” and “unreliable” and essentially claimed that the argument FOR flossing was a biased one.

The CDA (The Canadian Dental Association) of which I am a member, decided it was time to take a stand. We are fortunate to have an organization like the CDA to help present the public with the facts. The CDA went on record very shortly after that associated press article went viral to essentially counter the claim and put the public service announcement out there that in our collective professional opinion, we as dental professionals still very much advocate and believe in the use of flossing. To a degree the damage had already been done, many people were still touting this viral news flash as proof and permission to not floss.

So the CDA went on damage control and consulted authorities on the subject about how to help coach dental professionals on how to answer people newly armed with this so called evidence that flossing was really of no value.

Should you floss? Yes or No?
When a patient comes in to our Toronto Ortho office, and references these news articles littering facebook, here’s what we tell them.

  • The Associated Press article that contributed to this on going debate didn’t actually list any new clinical findings to support the claims that were previously cited in the The Cochrane review of 2011 . In fact that was the last sourced article on the subject of the efficacy of flossing.
  • The news that followed, and the constant stream of repetitive memes on the subject failed to touch on the many risks for developing tooth decay or gum disease.
  • Leaving out those important pieces of information and taking things out of context effectively mislead the public. It seems to have been championed mostly by people who are already looking for an excuse NOT to floss. In our opinion though, it’s an ill informed position and actually places the public at greater risk for tooth decay.

Flossing is important! It directly addresses one of the leading causes of tooth decay which is plaque build up.
Plaque is the white filmy material you see being scraped off your teeth when you do in fact floss.


We know that plaque leads to tooth decay if not addressed in regular hygiene appointments. Even when you are getting braces, you should still be seeing your family dentist for regular hygiene appointments.
Plaque doesn’t just go away on it’s own. There needs to be some intervention, where your teeth are professionally cleaned, and of course flossing at home!   If you don’t have braces but need a refresher on how to floss, see this page at the CDA on flossing.

While there is still debate on whether flossing alone will combat tooth decay (as suggested by the article of the AP) there is PLENTY of proof that plaque leads to tooth decay. So it stands to reason that the removal of plaque will reduce the risk of tooth decay. It’s just common sense. Flossing helps reduce the risk.

If you aren’t already doing so, you should be flossing daily, and even more important be sure to be seen by your dentist and dental hygienist regularly. As with all things, if you catch problems early, there is a much better chance of reversing the damaging effects and equally important, saving costly visits to the dentist.

Fluoridation in water. A hot topic. Be sure you are well informed.

Fluoride in Water

Recently a CBC article was published about the community of Moncton N.B., where the decision to stop adding fluoride to the water supply was implemented 5 years ago. The assumptions in that decision were that fluoride is somehow harmful to the body, and that fluoridated water is no longer needed to prevent tooth decay. Yet, as the article reports, there was a sharp increase in the incidence of dental cavities in that community over the past 5 years, indicating that perhaps drinking fluoridated water is more important in the prevention of tooth decay than the community thought.

Why fluoridation matters:

Tooth enamel is made up of crystals that dissolve in acid. When bacteria on the teeth consume sugars from the foods we eat, they produce acid that burns holes in our teeth, and eventually causes cavities. Fluoride, when applied to the teeth, becomes incorporated into the enamel crystals, making them more resistant to acid. This is how fluoride helps prevent tooth decay.

Some people believe that adding fluoride to water is no longer necessary because there is enough fluoride in our toothpastes to prevent tooth decay. What these people fail to realize is that toothpaste only affects the outermost layer of enamel, and can not penetrate deep into the inner layers. Relying on toothpaste alone makes our teeth hard on the outside, but soft on the inside.

Drinking fluoridated water, particularly as children, helps incorporate fluoride into all the layers of our developing teeth, not just the outermost layers. It also helps replenish our dissolving enamel over the course of the day as we sip it.

This is why drinking fluoridated water matters, and continues to matter. But the question remains, does fluoride cause harm to other areas of the body?

Fluoride in water is NOT dangerous!

Many anti-fluoridationists are quick to claim that fluoride is poisonous – which is true when consumed in large amounts, but not true in the tiny amounts found in tap water (about 1 part per million). Incidentally, many medicines and foods are equally poisonous in large quantities and helpful in small quantities (think Tylenol, penicillin, salt, or even water!).

With so much misinformation floating around (especially on the internet) we can be thankful that we have peer reviewed studies on this subject that show no association between fluoridated water and disease. It’s still concerning, in light of these studies, that the municipality of Moncton made the decision to stop fluoridating the water supply – a decision that has cost the public significantly, both in money and in health!

Tooth decay and general health are absolutely linked. There are countless peer reviewed, evidence based reports drawing clear connections between oral health and a person’s general wellbeing. From diabetes, to blood pressure and heart attacks or stroke, Oral healthcare is important and not to be taken lightly.

Hopefully, other communities will make decisions about the fluoridation of their water supply that are based on science and not on fear and misinformation. The primary goal of dentists, orthodontists, and other dental specialists is the health of our patients. If we, along with the medical community, are advising the public to continue fluoridating the water supply, it is because all the science we have available tells us that it is the right decision to improve your oral and general health.

The topic of fluoride is a hotly debated issue. In our humble opinion, we recommend you get your information from medical and dental providers rather than in a chat room! It’s just common sense!