Does flossing work?
What the trials and the professional bodies actually say
Home use of interdental cleaning devices, in addition to toothbrushing
Review of 35 trials in adults. Low-certainty evidence that flossing plus brushing may reduce gingivitis versus brushing alone. Evidence on plaque is weaker, and most trials were short.
Read studyFlossing and other interdental cleaners
The ADA recommends cleaning between your teeth once a day with floss or another interdental cleaner, because brushing alone doesn't reach there. A recommendation, not a trial.
Read studyPrimary prevention of periodontitis: managing gingivitis
European consensus: brush twice a day and clean between the teeth daily, using interdental brushes where they fit and floss where they don't. A consensus statement, not new data.
Read studyDental flossing and interproximal caries: a systematic review
Six trials in children aged 4 to 13. Flossing done by professionals on school days was associated with fewer cavities between teeth; self-performed flossing was not. Says nothing about adults flossing at home.
Read studyGum disease and the rest of the body
Observational links. None of these show that flossing prevents anything.
Toothbrushing, inflammation, and risk of cardiovascular disease
Observational study of about 11,900 Scottish adults. Those who reported never or rarely brushing had about 1.7 times the rate of cardiovascular events of twice-daily brushers. About brushing, not flossing; shows association, not cause.
Read studyPeriodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?
Scientific statement. Studies support an association between gum disease and vascular disease independent of known risk factors, but the evidence does not show that one causes the other, or that treating gums changes heart outcomes.
Read studyPorphyromonas gingivalis in Alzheimer's disease brains
Found a gum-disease bacterium in the brains of people with Alzheimer's disease. Does not show that flossing prevents dementia.
Read studyGum disease and diabetes
A two-way relationship, and what professional treatment does
Periodontitis and diabetes: a two-way relationship
Review. Diabetes is a major risk factor for gum disease, and severe gum disease is associated with worse blood-sugar control. A narrative review, not a flossing trial.
Read studyTreatment of periodontitis for glycaemic control in people with diabetes
35 trials. Moderate-certainty evidence that professional gum treatment lowers HbA1c by about 0.4 percentage points at 3 to 4 months. About treatment by a dental professional, not home flossing.
Read studyEvidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis
Professional gum treatment was associated with a modest improvement in blood-sugar control (about 0.36 percentage points of HbA1c) in people with diabetes. Small trials with a high risk of bias; about professional treatment, not home flossing.
Read studyEffect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence
A small body of observational evidence suggests gum disease is associated with worse diabetes outcomes. Observational, and the authors note limited generalisability.
Read studyPregnancy
Guidance from the obstetricians, not outcome claims
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