It is assumed that removing plaque (a layer of bacteria in an organic matrix which forms on the teeth) will help prevent gum disease (gingivitis) and tooth decay (dental caries). Gum disease, which appears as red, bleeding gums, may eventually contribute to tooth loss. Untreated tooth decay may also result in tooth loss. Toothbrushing removes some plaque, but cannot reach in-between the teeth, where gum disease and tooth decay are common. This review looks at the added benefit of dental flossing, in people who brush their teeth regularly, for preventing gum disease and tooth decay.
Twelve trials were included in this review which reported data on two outcomes (dental plaque and gum disease). Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult.