Calm: it is still too early to lay the floss to waste – Express

The news surprised the press – but above all the industry of dental hygiene products: after all, the famous recommendation to use dental floss to prevent problems such as tooth decay or gingivitis can not pass a myth with no real scientific evidence. The uproar began on Tuesday with the publication of an investigation by the Associated Press (AP) that realizes that suddenly, without notice, the recommendation to use dental floss is no longer part of the issued rules and reassessed each five years by the agricultural Services and Health and US Human Services – that’s the first time since 1979

Speaking to AP, the US government explained the decision, stating that “the effectiveness of. practice has never been proven, as required. ” Since the news came out, a succession of opinions of experts who argue that the dental floss use is not so useful and may even be harmful to the health of our teeth and gums – but the Portuguese experts are not convinced and ask for caution.

“Yes, remains the recommendation of flossing use to ensure effective removal of food debris between the proximal surfaces of the teeth, even if it is questionable your plaque removal capability (and even then the lack of robust evidence does not mean the extinction of the recommendation), “says the Express José Pedro Figueiredo, medical specialist in stomatology and professor at the Faculty of Medicine, University of Coimbra.

the absence
robust proof is precisely what is shown in the investigation of AP, which cites 25 studies on the hygiene practice conducted in the last decade to demonstrate that the conclusions of the studies recommend that the habit remains are “weak, few solid” and “low quality”, having a “moderate bias high” risk. Moreover, the agency argues that the studies cited by the American Dental Association to defend the practice “use dated methods or small samples.” “Some lasted only two weeks, sufficient time for a dental disease or caries develop. One tested 25 people after a single use of dental floss. “

The fall of a multimillion-dollar industry?

The truth is that, keeping or not the recommendation by the experts, the attention the media is giving the investigation of AP may mean a hole for a successful industry, the agency calculates to be about to be worth EUR 2 billion next year. Two of the companies that produce dental floss already reacted – Johnson & amp; Johnson defended the benefits to reduce plaque, but declined to comment on the contradictory studies cited by the AP; now Procter & amp; Gamble argued that flossing prevents gingivitis, but for that used a study that lasted two weeks and was in 2011 considered scientifically irrelevant.

While the investigation indicate that the benefits of flossing are not proven by science the Portuguese experts warn that can be thoughtless stop using this tool. “The devaluation of dental floss to use recommendation does not seem sensible to me,” says José Pedro Figueiredo, remembering that we are witnessing a general alert for a “further increase in oral hygiene gestures.” “The high prevalence of oral health problems of the Portuguese (tooth decay and gum disease) recommend, instead, proactive measures of information and education to the population.”

Also the Medical Scientists Portuguese sharing the same view, stressing the Express that while flossing is not the first recommendation to make, this habit should not be discarded. “The fundamental basic routine” recommended by the Order is to “brush your teeth twice a day with a fluoridated toothpaste for about two minutes and consult a dentist twice a year.”

However, he insists the organization, “it is still important to take proper care of your teeth and gums, the cleaning of interdental spaces with dental tape, interdental pipe cleaners and professional cleaning.” “The daily cleaning of the interdental spaces where the brush does not reach is essential for the removal of food waste.”

Experts urge caution and precaution

The new investigations should be taken into account, grants Maria Helena Figueiral, full professor of the Faculty of Dental Medicine, University of Porto, since “knowledge is constantly updated.” “We have to be wary of the huge amount of information that every day we will coming,” he stresses. However, the expert points out that, for now, “the thread tooth is indicated for the general population and its use right should be encouraged.”

continues so in Portugal the recommendation to prevent cavities, gingivitis and reduce plaque with the help of dental floss – Rita Alves, dental hygienist Clinic Hugo Madeira, Lisbon, continues “to defend its use as a complementary method of oral hygiene” and endorses the view of the dental Association: “the daily oral hygiene using only the use of manual or electric brush is not sufficient in regard to efficiency of plaque removal, since the filaments of the brushes can not reach the interproximal spaces” and therefore the wire must be used “once a day at night before bedtime.”

Portuguese do not use dental floss

the idea of ​​the benefits can not be effectively proven may seem strange – after all, we hear the recommendation of the use of this instrument from children and their invention dates back to the nineteenth century. He wrote the dentist and inventor of dental floss Levi Spear Parmly, quoted by “Time” in 1819: “The remains of what we eat and drink are to accumulate, stagnate and decay between the teeth and are the cause for most dental problems . [The dental floss], although simple, is the most important and should be passed to dislodge those annoying remains that no toothbrush can remove. “

In the United States, the recommendation has become general practice of dentists from the beginning of the last century, and even today – even passing the yarn to be made of nylon, not silk – remains the habit. In Portugal, although experts maintain the recommendation, the impact of the news should not be significant: is that according to the III National Study of Prevalence of Oral Diseases, conducted in 2015 by the General Directorate of Health and the Dental Association and released by Lusa, the vast majority of Portuguese do not have this habit. The study revealed that even in the age group that most uses this instrument, from 35 to 44 years, their use is given in less than half of the cases; for more, 65% of 18 year olds do not use dental floss and in the case of older people, aged 65 to 74, the percentage rises to 82%.

[Original text published in the Express diary of August 3, 2016]