Flossing only helps with gingivitis in which case mouth rinses perform better.
In the studies that do show flossing helps against cavities they are about professional flossing and not self flossing.
So dentists continue to push unfounded claims regarding flossing.
That’s actually a misrepresentation of the studies. It gets pushed by journalists because contrarian “doctors are wrong” takes are very popular, especially when they tell people what they want to hear.
The issue with flossing is that it’s hard to rigorously study over the duration needed to provide significant results. You also can’t really construct a study where you ask one cohort to not study for a couple decades to see if they do worse, because that has ethical concerns. So we’re left with self-reported flossing activity retrospectives. The problem with those is that people who floss tend to have better hygiene and self-care overall, so now we can’t isolate flossing as the reason for better dental health over a lifetime.
> In the studies that do show flossing helps against cavities they are about professional flossing and not self flossing.
This is an example of what I’m talking about: There are studies out there that show positive benefits of flossing, but if you find someone aggressively searching for reasons to discredit flossing then they’ll always find a reason to dismiss the evidence. When the goal becomes to be contrarian or to disprove something, you can always find a reason to dismiss the studies.
Look at all the wives tales in the past that were semi-effective just because of placebo effects or like you say implementing a health measure (even if it is not directly effective) normally means you have better hygiene anyways.
The problem with flossing is that it is so easy to do wrong which is why only professional flossing has significant effects.
It’s worth people knowing that unless they are flossing on a professional level they aren’t necessarily doing anything to benefit themselves beyond what a mouth rinse would do.
From experience: I used to rinse AND floss, and the floss always came back with a little bit of organic matter which would’ve otherwise decomposed.
So arguing against floss in praise of mouth rinses doesn’t seem like such an obvious ‘just do it’ idea. It’s probably more nuanced than that. And you can always use the wrong rinse or rinse incorrectly.
The burden is on the flossers to prove the efficacy beyond a secondary link and prove flossing is better in a controlled study. reality doesnt always match what they “feel” it should be.
No, you're missing my point - the secondary link is the study of flossing w.r.t. oral health outcomes. The primary (causal) links are whether flossing removes food particles, and whether food particles cause tooth decay (neither of which seems to be under contention here). By just studying whether flossing improves oral hygiene, you're introducing a huge number of variables that are difficult to control for (flossing skill, other hygiene factors like flossing or "rinsing", dietary choices, self reporting errors, etc etc etc).
(edit: to summarize: A causes B, B causes C, but you don't like saying A causes C because people kind of suck at A, and D, E, and F all also cause C which makes studying the relationship between A and C a challenge)
I can't speak to flossing in general, just as a specific action that helps me feel better. I still get cavities despite brushing twice a day for two minutes each with fluoride toothpaste, waiting at least 20 minutes to brush after eating (especially after sugar or acids), and sleeping with my mouth closed (starting a few years ago after reading Breath by James Nestor- vertical surgical tape on my lips and sleeping on my back, took about 6 months before I could do it without the tape).
I also stopped bruxating by relaxing my jaw every night before bed and, for the first few weeks of this, waking up frequently to make sure my mouth was still closed and my jaw relaxed.
It’s generally accepted if you are flossing then generally you brush more often and more completely and in overall better mental and physical health than if you aren’t flossing because if you take the time to floss you are paying attention to your body.
But controlled studies haven’t found floss to be effective as mouth rinses and brushing.