Elsevier

Dental Abstracts

Volume 63, Issue 1, January–February 2018, Pages 20-21
Dental Abstracts

Hands On
Flossing recommendations

https://doi.org/10.1016/j.denabs.2017.09.016Get rights and content

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Background

Based on current evidence the Dietary Guidelines for Americans 2015-2020 have now removed the recommendation for flossing as an oral health measure. This may represent an inaccurate assessment of the evidence regarding how effective flossing is in caries prevention, and it may have significant implications for other current and future public flossing guidelines. The evidence was carefully examined for methodological deficiencies. In addition, a valid, reliable, provider-observed measure of

Flossing Effectiveness and Skill

Flossing can be challenging in certain areas of the mouth, even for non-disabled individuals. In addition, flossing may be difficult in unique and/or challenging dentition or for young children and their parents. Some individuals cannot reach or effectively floss in certain areas, so a “food trap” develops, where food particles and dense plaque accumulate between the teeth. Interproximal tooth decay can develop more readily in these areas than where flossing is accomplished more effectively. If

Interdental Brushes Versus Flossing

The European Federation of Periodontology (EFP) has recommended that interdental brushes (IBDs) be used rather than flossing, except where contacts are too tight for the IBDs to be used. The basis for this recommendation is derived from low-quality evidence with many methodological shortcomings. Few of the studies assessed participants' flossing skill, often interproximal sites where IBDs did not fit were excluded from consideration, and frequency of flossing was self-reported by the

Application to Clinical Care

Oral health care providers should tailor their health advice to the clinical presentation, risk assessment, and personal and demographic factors of each specific patient under their care. This prevention-focused behavior should lower the risk for dental caries.

If flossing is a challenging skill for patients, the dentist and other health care providers should be able to provide appropriate education and demonstration, as well as follow-up corrections as needed. To ensure this is the case, oral

Oral Hygiene Skills Mastery Tool

The National Institutes of Health (NIH) has developed the Oral Hygiene Skills Mastery (OHSIM) measure to assess key oral hygiene competencies to guide the coaching of specific technical skills. OHSIM was originally designed to address flossing in the context of periodontal disease, but it may prove useful in future clinical studies that address flossing in relation to dental caries.

Clinical Significance

The developmental courses of clinical caries and periodontal diseases are multifactorial and

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Vernon LT, Seacat JD: In defense of flossing: Can we agree it's premature to claim flossing is ineffective to prevent dental caries? J Evid Base Dent Pract 17:71–75, 2017

Reprints available from LT Vernon, Case Western Reserve Univ School of Dental Medicine, Dept of Pediatric Dentistry and Community Dentistry, 10900 Euclid Ave, Cleveland, OH 44106–44905; e-mail: [email protected]

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