Hacker News Reader

Comment by Waterluvian | Hacker News Reader

I didn't really know that not flossing every day was even an option. To me that's equivalent to seeing a blog post saying, "changing my underwear every day was one of the best habits I formed."

Now, I'm not trying to rag on the author. I just think it's a great reminder that my personal life context is not the same as everyone else's.

View on HN

Never flossed, never heard of anyone flossing in my circles.

It seems like a very country specific thing, and afaik studies find very little to no benefits to flossing.

People look at me weird when I tell them I brush my teeth three times a day, here it seems like people are told to do it twice per day.

Same. Brush 3 times daily, never really floss. Not sure about the benefits, but my dentist doesn't complain. Then again, this is Britain.

My dentist in the US said to me that they would actually prefer people to brush less and floss more. They made a point of saying that if you brush twice a day and don't floss at all, they would instead prefer you to brush once a day and completely replace the other brushing session with flossing. (The ideal is brush AND floss every session, but they've learned that just telling people to do that results in them not actually changing anything)

I honestly don't know how good of advice that is, but I brush and floss daily, so it wasn't really directed at me in the first place, hah.

I gave up flossing. It has made no difference as far as I can tell, and my dentist hasn't noticed. As far as I know, research has been ambiguous on the benefits and it's been dropped as a recommendation by some organisations because of the lack of evidence.

The change that did make a difference to me, and is supported by evidence: switch to an electric toothbrush.

Might depend on what you eat but when I first started flossing, the gunk that I saw being removed was enough to convince me that flossing was a good idea.

It may depend a lot on the tightness between your teeth, for example, how beneficial it is?

It surely depends on how your teeth are aligned. Without flossing if I eat red meat for example every single time some get stuck and brushing never gets it out. My wife with the same meal never ever had this problem (or did any flossing btw)

I brush every single time i eat. Even if it's a snack. WFH forever helps make that possible.

Not immediately after eating I hope, that would do more damage than not.

Why is that?

If you ate something acidic, brushing might just rub the acid into your teeth. I’m not quite sure how big of a deal it is but that’s my guess as to why you want to wait a bit.

Acidic foods and drinks will temporarily soften the enamel in your teeth. Brushing right afterwards can remove the softened enamel.

Brushing right after drinking acidic soft drinks or soda is meant to be much worse for your teeth than not brushing.

Thanks for this comment. Going to change my eating habits as a result.

I thought one weird trick to having good teeth was outright avoiding sugary drinks (soft drinks) and snacks. I always assumed avoiding causes was more important than remediation (teeth cleaning). Anecdotally, it seems reasonable.

That said, flossing gets rid of obvious stuck gunk, so I do that (with care to avoid damaging gums).

It's not just sugar. Soda water would do it too.

And it's not just carbonated beverages. Tea also is acidic

This is exactly right. If you really want to brush after eating acidic foods, at the very least swish generously with water first. Ideally, use a pre-brushing rinse that restores your mouth's pH balance.

To add to the other responses, using a straw can help, it gets the liquid past your teeth.

In part too the sugar with acid combo is particularly impactful, the sugar acts as an abrading agent. Hence, smoothies are something to take care with too.

One culture shock while in South Korea is that people who brush their teeth after every meal in the office. Teachers would even walk around the hallway with a tooth brush in their mouth.

If your foods contain acid, you may be causing rapid damage to your teeth by doing this.

Make sure you aren't hurting your gums.

(it's an awareness thing that is worth mentioning; if you are already aware, then no problem)

I'm curious, as some cultures also have toothpicks on every restaurant table and toothpicks seem as if they might provide similar benefits to flossing...do people in your country use toothpicks a lot?

The main purpose of flossing is to scrape the narrow sides of the teeth, not to remove material from between the gaps.

Ah, I appreciate that answer, thank you!

> afaik studies find very little to no benefits to flossing.

My gut reaction to that statement was incredulity, but the intro to the wiki article for flossing confirms it:

https://en.wikipedia.org/wiki/Dental_floss

> ...empirical scientific evidence demonstrating the clinical benefit of flossing as an adjunct to routine tooth brushing alone remains limited.

Who knew?! I'm not going to stop flossing though. I didn't always and I believe it had a very positive impact on my gum health in particular. I always get high marks from the dental hygienist.

There's little evidence that check ups/cleanings do anything either. Same goes for annual physicals.

I would like to recommend the book Kiss your Dentist Goodbye, by Ellie Phillips, DDS. If you want to understand oral hygiene this book is great. It also has a care program involving three different mouthwashes!

Well there's a surprise, my hygienist and dentist always encourage flossing, and anecdotally my gums are way happier (no bleeding or puffing) when I'm flossing daily compared to when I'm not. I guess it could be that however my mouth is configured, and with the types of food I generally eat, I benefit from flossing but many others with different mouths and diet wouldn't.

Same here. I've had ups and downs with flossing (going months at a time with and without it). Without fail, when I see the dentist/hygienist, for the times I've not been flossing they can easily see my gums are in bad shape.

Anecdotal, but still.

I think the tell is mostly that gums bleed after flossing if they haven't been flossed in a while.

Yeah that's normal if you haven't flossed for a while. Goes away within a week or two.

I do floss, but I always think that it’s unintuitive that something that literally causes bleeding when you start doing it ever came to be regarded as a good thing.

I think it’s unintuitive that someone looked at wheat and thought “let’s try eating that” and now we crush grass seeds to make bread on a massively industrial scale. It only takes one person to do a thing for others to copy it.

I think healthy gums do not bleed, bleeding means they were inflamed to some degree. Its not a case of flossing simply toughening up your gums.

Hygenist explained it a bit differently to me. The presence of blood is the body trying to wash away microbes and other stuff that is getting behind the gum line. The presence of blood (carrying white blood cells) and microbes cause inflammation. FWIW

Hence, no gunk, no microbes -> no bleeding gums after flossing

The other interesting tidbit i learned from that hygenist is that microbes grow on the food and gunk on your teeth, they don't attach directly to the enamel.

That makes sense. I also read somewhere that flossing is not just important to disloge macroscopic food pieces it also helps disrupt bacterial colonies that can set up in between teeth, and every since then I’ve flossed more since I know its doing something even if I can’t see it.

If your gums are regularly bleeding after each flossing round, either you're applying too much pressure with the floss (you don't need to cut your gums) or likely using a low quality floss.

I have sensitive gums and a small mouth, so my teeth have very little space in between them (thanks nature). Thanks to my dentist, I found that using higher quality floss resolved the bleeding completely, because I need to apply way less pressure to get the floss in between teeth, so it never whips/cuts the gums.

Waxed floss is better than non-waxed if I am traveling and forgot to pack it, but expanding floss is miles ahead of both.

I regularly use this one, and haven't had a gum bleeding in months: https://www.amazon.com/GUM-Expanding-Dental-Floss/dp/B01LXFT...

The thread is thinner than waxed/non-waxed thread so it fits more easily, and once you put it in between your teeth, you can remove the tension from the thread and pull it with just one finger -> the expanding thread helps to clean the gunk also from teeth walls and other places that are harder to reach with regular floss.

Do you not have a Sonicare toothbrush? I felt flossing became pointless when I switched as there was never anything left after regular cleaning

I have a Sonicare toothbrush and still see gunk accumulate when I use floss

I’m incredibly lazy about dentist appointments but whenever I have gone they’ve seemed happy. I’m pretty sure the Sonicare is magical.

flossing work on very deep part, so brush can't replace them.

I still floss, but you're spot on with the Sonicare. I wonder if there's a way to track Sonicare usage and dentists making up new stuff to sell you since general dental hygiene improved.

The thing is, the half-life on this is ridiculously short. My approach now is to start flossing ~2 weeks before my biannual dental appointment. I always receive high praise about my gum health.

Take from that what you will.

Hadn't flossed (or rather used interdental brushes) for a few years, went to the dentist and they saw a lot of issues that needed fixing.

My dentist told me it depends a lot on your individual mouth chemistry.

The main problem is that there are zero long term studies on flossing.

Gum recession and Gengivitis take decades to develop, until you are old and don't have enough of gums left to hold your teeth.

Decades? Nah just a few years is all you need, a lot of it is more apparent from eating disorders. Even with flossing + brushing daily it can be hard to overcome for some people once you have it.

Sadly can confirm as I had no cavities in high school, did terrible in my 20's especially around 20-27 went through a lot of depression, lack of money/medical care/ in and out of work a lot and I'm trying to fix what I can just starting my 30's after losing 2 teeth It can be hard to overcome shame when already depressed so it's hard to visit a dentist moreso if you have no money to do anything.

It's easy to screw up even more so if you have bad genes on top of it, a lot of my family has issues with teeth.

At least stem cells can be found within your teeth and there is a process now to regrow some of your teeth with your own stem cells, doesn't replace implants though but helps. This process isn't popular yet but at least it's possible in a few areas in the states.

Lost four teeth when my fillings kept popping out, then eventually was told "you'll need crowns, those will be $2500 apiece" while I was in between jobs.

I ended up letting them rot until they needed pulled, and that was something I wish I could take back today. I eventually was able to afford to get two dental bridges put in, but I've had issues with them off and on ever since: one of the anchor teeth needed a root canal and eventually cracked in half, now I need to get that and the other tooth pulled and get implants at some point.

And I've got pretty bad gum issues around one of the anchor teeth (a pocket of size 5, just under serious periodontal disease) on my other bridge, and have gotten it deep cleaned and given antibiotics under the gumline a few times that so far hasn't reversed the process at all.

If I could go back in time I'd be more diligent about dental hygeine, and/or would have borrowed money from someone or sought cheaper ways to get those crowns in, because it's a lot easier to keep crowns flossed than bridges.

The main problem with a lot of studies of oral hygiene is that peoples oral hygiene technique is often really bad/variable.

Like, people who floss often floss with poor technique so it is hard to study the benefits of flossing vs not flossing.

Peoplevs toothbrushing technique is all over the place so hard to study the benefits of electric tooth brush vs manual.

Etc, etc.

It seems to me like this is a more important issue than most people realize. Most things in life come down to the small details of execution, and behaviors like oral hygiene are even harder to teach and monitor.

That looks a similar situation to that famous "we found no evidence that parachutes increase the chances of survival when jumping out of a plane" joke study.

It looks like a very difficult study to conduct, and will certainly give you a very predictable result.

I remember looking into this and being surprised it was controversial when DHH (lol) got up on a soapbox about how flossing was a scam promoted by Big Dental.

> the intro to the wiki article for flossing confirms it

How does a Wikipedia article confirm anything? It might give you a lead on something, but while the mis- and disinformation in our world is alarming, people's blithe openness to it is even worse.

You just blew my mind. The way dentists freak out about it, you'd think not flossing = guaranteed dentures by the time you're 50.

> Who knew?! I'm not going to stop flossing though. I didn't always and I believe it had a very positive impact on my gum health in particular. I always get high marks from the dental hygienist.

My best guess is that a person willing to floss daily is a person who is willing to take care of themselves in general.

I remember being taught in school (United States in the early 90s) to brush teeth three times a day. This seemed odd to me since no one brought a toothbrush to school to brush after lunch.

Not sure about the evidence/research, but proving that flossing does more than brushing seems simple enough: just brush until you are satisfied, then pull out the floss and see what it pulls out from in between your teeth. Flossing never fails to extract some amount of food when I do it.

My dentist said something similar, that flossing will pull a bunch of stuff out of my teeth. I never floss and on the rare occasion I do nothing comes out, maybe a little blood. I don't know if anyone else has experienced this, I don't really floss anymore though as it just feels like jamming string between my teeth for no reason. Never had a cavity or dental problem of any kind, in my mid 30s. Floss once a month maybe.

> Flossing never fails to extract some amount of food when I do it.

Now, prove that that amount of food actually does damage, and you have something.

Does halitosis count ? ;P

Yes. If all flossing does is cut down on the bad breath, that's still a benefit.

Wait, what? People can see stuff bring removed by flossing?

That has never happened to me, unless it’s something obvious like a piece of peanut skin that got logged in there somehow. Usually, the floss starts and ends looking pretty much the same.

The silky smooth PTFE-based floss doesn't, but the cheap store brand floss is rougher and does a much better job cleaning.

Me neither. Probably a genetic thing about the shape of the teeth. I don't notice a smell when I floss either.

When I was in elementary school we were shown training materials which recommended that we brush there times a day.

When we would ask the teacher how we should arrange to do so as young school students, the response was always something like, “Suppose we change the subject …”

I go to the dentist every 2 months. The effects of not flossing, vs flossing once a day, vs flossing twice a day are very noticeable. Though I was cautioned to not floss aggressively, as that will wear down the tooth enamel.

Noticeable doesn't mean beneficial. Also dentists are very prone to over recommend things, because they're either directly or indirectly paid to do so. https://academic.oup.com/ej/article-abstract/130/629/1346/57...

Go to 5 dentists you'll get 5 widely different diagnosis. I was supposed to get my wisdom teeth removed "very soon" or I'd suffer in the future, that was almost 20 years ago, never had a toothache, never had a cavity, never had any issues with my wisdom teeth

My dentist recommended pulling my wisdom teeth over 40 years ago. I still have them, and they are the healthiest teeth in my mouth. (I switched to another dentist.)

Another time the dentist wanted to put in a crown, I had him do a filling instead.

And so on. One needs to be a participant, not just do whatever the dentist says.

It's quite clear, though, that flossing fixes the obvious inflammation of the gums. At least in my mouth, it does.

One of my dentists had a little embroidered sign on the wall:

"Floss only the teeth you want to keep."

My main motivation for flossing aside from fresher breath is it dramatically makes the next dental visit easier. Meaning, way less bloody and painful. But my dentist says only about 30% of patients floss regularly.

I’ve never brushed my teeth more than once a day, and people in some circles say that’s crazy.

I recognize that it might be better to do it twice a day (like doing it three times might be better still?) but breaking the habits of a lifetime is hard, with uncertain gains.

FWIW, many years ago I used to have a real problem with bleeding gums whenever I brushed my teeth (mainly around my molars). Flossing daily solved that completely.

I've similarly observed massive improvements doing it daily, but in general people tend to have very strong opinions one way or the other which makes me think it's very dependant on the teeth's in-between distance, microbiome, brushing technique and more.

Some people can just like brush once a day with a regular toothbrush and have perfect teeth, meanwhile some of us have to do scientific experiments, use sonic toothbrushes, floss, and use mouthwash or our teeth start falling apart immediately lol.

Sadly I fall in the "scientific experiments" group! :) I don't think my wife even needs to floss.

I think it's more the case that the benefits of flossing haven't been studied much, not that it's been thoroughly investigated and found not to work.

If I don't floss my breath stinks. So I floss.

The thing I wonder about is the "wax" on waxed floss. Am I shredding PFAS (forever-chemicals) all over my mouth?

Waxed dental floss seems like the exact use case for PFAS - making something non-stick/slippery.

And...after searching instead of wondering - yes some flosses contain PFAS. https://www.buzzfeednews.com/article/nidhisubbaraman/oral-b-...

How do you know your breath stinks? Isn't that really hard to detect on yourself?

Look in the mirror, and if the back of your tongue is white or white-ish at all, your breath stinks. That white stuff is bacteria.

Did not realize this until my 20s. Most people don't tell you when your breath smells bad.

But does your breath stink? There will always be bacteria in your mouth. Doesnt mean it will always stink.

Well you can easily try it. Scrape a chunk of the white off the back of your tongue, and smush it between tour fingers. Does it stink?

Take a metal teaspoon, scrape your tongue, and sniff it.

The first nationally representative analysis designed to determine how many people floss their teeth found that those who floss daily amount to 30 percent of the population. Just over 37 percent report less than daily flossing; slightly over 32 percent say they never floss. -- https://www.usnews.com/news/articles/2016-05-02/how-many-ame...

And if you asked me to estimate the % as a kid, based on how my parents treated not flossing (as much an offense as swearing), I would say... maybe 5% don't floss.

I'm fascinated by the delta between what's typical, and what I grew up thinking typical is.

I'll reply here because a lot of sibling comments mention not seeing benefits to flossing, there being no evidence, etc.

Not cleaning interdentally (between teeth) means you miss almost half of the tooth (crown) surface. Think of it as only cleaning the outside of a vintage radiator [1].

The current guidelines [2] recommend using interdental brushes when possible (lots of evidence for that), and flossing where space is really tight.

So, please, clean interdentally!

[1] https://upload.wikimedia.org/wikipedia/commons/8/8a/Vintage_...

[2] https://www.efp.org/for-patients/gum-diseases/gum-disease-pr...

I don't floss, but I started using interdental brushes at about 30 years of age and my gums are very happy. I had significant teeth problems before, and the old mistakes obviously have consequences until today, but development of any new problems has slowed down to an almost negligible crawl.

I’m pretty sure it has to do with genetics. I asked my dentist friend and he confirmed. The only reason I was interested in this is because a friend of mine in his 40’s has absolutely perfect teeth and has never flossed once. His teeth are insanely white and clean. I’m extremely envious! I have to floss twice daily. I assume it’s a bacteria thing? I have no idea.

Last time I went to the dentist he told me that things looked good and to “keep flossing”, even though I never floss. I assume if a dentist can’t tell if I do or do not floss, there mustn’t be much of a tangible benefit.

I found using those little between-teeth brushes a good substitute. One push of that between each tooth each time I brush did wonders for the gums - blood from gums during brushing became a thing of the past.

For anyone who doesn't floss, I would just say: If you've eaten any meat, floss your back teeth and sniff that big chunk you dislodged. That foul mass just sits there if you're not flossing.

One of the top uses of Beeminder? Flossing daily.

https://www.beeminder.com/

Reply on news.ycombinator.com