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Comment by cainxinth | Hacker News Reader

> 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.

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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.

> 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.

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.

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.

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!

> 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.

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.

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.

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