Comment by w0utert | Hacker News Reader

Comment by w0utert | Hacker News Reader

FTA: Just recently I decided that I would give myself another dental check up. I seemed to have forgotten my horse racing lesson because I was expecting to have perfect teeth, again. I didn’t. I was given a bill that would be the equivalent of buying a decent used car. Ugh. Could I have prevented this? Yes, I could have. If only I had been flossing my teeth two times a day, I would have had less problems.

My personal anecdote: last time when I went to the dentist, for the first time in ~10 years, because a tiny bit of a tooth broke off while trying to strip a piece of wire with my mouth (yes I know that's bad), I expected my teeth to be in horrible shape. Dentist fixed my tooth and did a full check-up including X-rays, and as it turns out, my teeth where in near-perfect condition, no cavities or other bad spots, just some dental plaque that needed to be removed. I haven't flossed a single time in my 30+ years long life.

Moral of the story: flossing probably has nothing to do with dental health, as long as you brush your teeth and don't eat a lot of sugar.

There are many factors that affect tooth decay and plaque buildup including the microbial content of your mouth, your diet, and the amount of saliva produced.

But one thing that is clear is that oral health is very important. I've noticed that when I brush around midday, I'm in a much better mood. But don't take my word for it -- numerous studies have established co-incidence between heart disease, mortality, and inflammation and bad oral health. And there are good reasons to believe it is not simply an issue of correlation without causation as local even mild infection can cause many downstream effects throughout the body. And anyways, it's just so much better to have a clean mouth.

Flossing has everything to do with dental health. It's just that dental health has everything to do with cavities when you're young, and everything to do with gum health and gingivitis when you're older.

Moral of the story: flossing probably has nothing to do with dental health, as long as you brush your teeth and don't eat a lot of sugar.

It is unwise to extrapolate from your personal experience. Especially when there is plenty of research available on the effect of flossing on one's dental health.

I'll see your anecdote and raise you one ;-).

I never used to floss, and would regularly have cavities to deal with (pretty much every visit to the dentist). When I started flossing religiously that ceased. I've had one filling (and that for a tooth cracked when I accidentally bit down on something hard) in the last decade.

For me, there's a pretty clear benefit to flossing. I imagine there's a lot of variation in its usefulness, depending on things like diet, mouth shape & size, what kinds of bacteria you host, etc.

You are a statistical outlier, and your conclusion is completely unfounded.

I get it. When our experience is exceptional, we see the need to share, but you're taking away the entirely incorrect lesson from your own experience, and from the author's blog post.

The author was using flossing as a metaphor for a common oversight: just because things are one way today doesn't mean they'll always be. Well, duh. Yet, we all forget it. It's the same reason that investment advice is given with the caveat that past performance is not to be used as a determinant of future results.

I disagree with the author's approach though. I've also never had a cavity in my life. Just turned 36 today. I also have excellent gum health. I floss, at most, once a month. The difference between my experience and the authors is that I continue to go to the dentist every 6 months.

My dental health is fine without flossing, so why should I floss? The author's contention is that this could change at any time. I agree, which is why I get regular dental check-ups. The assertion that I should floss anyway is just acceptance of dogma. I don't buy it. The important part, in my view, is that you always keep an eye on conditions. At the first sign of change, I will adapt my routine to accommodate.

Genetics, and how much flouride you got as a child, also make a big difference. Some people have to fight against tooth decay a lot more than others. (I'm more in your category, but have to be careful about my gums.)

Actual moral is probably that some people have better teeth than others.

I guess the molar of the story is clear.

Great comment!

If you experiment with various size interdental brushes (search on Amazon), you will quickly realize that there can be a lot of differences in dental spacing. Some people might mostly have tiny spaces between their teeth, while some have larger spaces, which will collect much more food residue. Leaving that residue in place can cause your gums to bleed pretty fast, which means you will have problems.

Moral of the story: get to know your own teeth well and take care of them in the way that's best for you. You might not even realize how much food is constantly stuck between your teeth, if you never used an interdental brush. Flossing is complementary to them.

Or maybe the moral is that young people are generally healthy and thus are not a great population to study when judging the efficacy of health habits?

Out of sheer curiosity: do you never get food stuck between your teeth? I don't floss too often, but whenever there's something stuck between my teeth that I can't get out with my tongue, it drives me nuts and really distracts me. Do you never eat popcorn and chicken and pork?

Ah, but do you use toothpicks?

One DH told me that toothpicks are better.

Flossing isn't about your teeth so much as it is about your gum health. Nasties that get in your gums will get into your blood stream, and there's a high correlation between gum inflammation and generalized inflammation, even heart attacks. Some researchers even believe that inflammation that starts in places like your gums is a cause of heart disease, rather than just a comorbidity. This is not a very "out there" hypothesis, either.

Don't skip flossing just because you haven't had a bunch of cavities. Your teeth may be special, but is your heart?

OT, but just to understand: are you referring to the Focal Infection Theory when talking about gum infections causing heart disease?

I ask because Wikipedia[0] believes that the theory is still quite "out there" but I'd be happy to learn from more up to date/reliable sources.

[0] http://en.wikipedia.org/wiki/Focal_infection_theory

I can't remember which book I read it in, but no, it wasn't about the focal infection, but rather the inflammation markers. Inflammation changes blood chemistry (blood cell mix, the "stickiness," and other chemical markers) and there's good reason to believe there's no such thing as "local" inflammation when it's an internal organ (vs, say, a rash on your elbow). And like circulating hormones in response to a grievous injury, these changes can cause a cascade effect.

Meh, observational data sucks. And the cohort studies (with treatments) don't seem to have been compared with a control group. Just before/after. Way more important to be lean and active.

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