If Flossing is Out, Prepare for a Lot of Bad Breath

Are Americans wasting $448 million a year on dental floss?


“There’s little proof that flossing works,” the Associated Press reported weeks ago. According to the AP story, since 1979, the federal government has recommended flossing, most recently in its Dietary Guidelines for Americans. In the federal government’s latest dietary guidelines issued this year, the flossing recommendation was removed. “In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched, as required.”

The news organisation examined 25 different studies about the effectiveness of dental floss and concluded that evidence for its benefits is “weak”.

Floss sales have increased in the US over the past decade. Americans spent about $448 million on floss in 2015, up 12 per cent from $394 million in 2005, in part because of population growth and increased interest in preventive health measures because of rising healthcare costs, according to data from market research firm Euromonitor International.

Still, floss makes up a small percentage of consumers’ overall dental product purchases. Toothpaste makes up 40 per cent of the sales in that category, followed by mouthwash at 22 per cent, toothbrushes at 19 per cent and floss and accessories at 16 per cent, according to market research firm Mintel, which reported that the difference is partly because toothpaste and mouthwash have to be replaced more often than toothbrushes and floss.

Although sales of floss grew about 4.4 per cent from 2010 to 2015, they’re projected to slow to 2.2 per cent from 2015 through 2020, but don’t blame the AP’s report, said Ms. Eleanor Dwyer, a research associate at Euromonitor. Instead, it’s likely to happen because more households are well-stocked with floss than they were in the past, and they don’t need to keep buying it, she said.

“I don’t expect this new report to impact floss sales dramatically in the short term, as there is no compelling new evidence that it is harmful,” Ms. Dwyer said in an email. “People can physically see the plaque and food particles removed by floss, giving them personal confidence in its efficacy.”

“As long as dentists continue to promote daily flossing, consumers will likely follow that advice,” said Ms. Margie Nanninga, a beauty analyst at Mintel.

The AP’s report shouldn’t discourage people from flossing, said Mr. Marcelo Araujo, vice president of the American Dental Association Science Institute.

“This will trigger a great conversation between patients and dentists,” Mr. Araujo said. “It could lead to people looking back at what they are doing every day and what kind of products they’re using and asking the dentists how to use the products and what the best ones are.”

After the AP’s report, the ADA said on its website that the organisation recommends brushing for two minutes twice a day with fluoride toothpaste and cleaning once a day with an “interdental cleaner”, such as floss. (That recommendation wasn’t in response to the AP’s story; it remains the same as before the story came out, an ADA spokeswoman said).

“Together with food debris, water and other components, the plaque build-up around the teeth and on the gum line will contribute to disease in teeth and gums,” the statement says.

Flossing can remove plaque bacteria and debris that brushing alone can’t reach, said the American Academy of Periodontology, an organisation of more than 8,000 dental professionals, on its site, after the AP’s report.

Even before the AP’s report, Americans have shown some resistance to flossing.

About 27 per cent of adults lie to their dentists about how often they floss their teeth, according to a survey of about 2,000 adults the AAP did in March 2015. More than a third of those surveyed said they’d rather do an unpleasant activity such as cleaning the toilet or waiting in a long check-out line than floss daily. – Maria Lamagna