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Surprisingly Little Evidence for the Accepted Wisdom About Teeth

Author: David Blumrick/Friday, September 02, 2016/Categories: Dental

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I brush my teeth twice a day, but not for as long as my dentist would like. I’d like to say I floss regularly, but that would be stretching the truth. I don’t scrape my tongue, I don’t rinse with mouthwash and I don’t use an interdental brush or Waterpik. However, I have one filling in my mouth, and I got that only when I had braces as an adult 15 years ago.

My wife, on the other hand, cares for her teeth fastidiously. She does all the things you’re supposed to do, and then some. But she has more fillings than I can count. I remember once, years ago, when one of her teeth broke while she was eating scrambled eggs.

Clearly, the stuff we’re doing might not make as much of a difference as we think. A couple of weeks ago, many of you were shocked to learn that the evidence supporting flossing daily was as thin as, well, dental floss. That’s just the beginning. 

As my colleague Austin Frakt pointed out recently, for adults without apparent dental problems, there’s little evidence to support the use of yearly dental X-rays. This still doesn’t prevent many dentists from recommending them for everyone.

With respect to flossing, this shouldn’t have been news either. A systematic review in 2011 concluded that, in adults, toothbrushing with flossing versus toothbrushing alone most likely reduced gingivitis, or inflammation of the gums. But there was really weak evidence that it reduced plaque in the short term. There was no evidence that it reduced cavities. That’s pretty much what we learned recently.

What about everything else? It turns out there’s a whole journal dedicated to the idea that we could use more rigor in dental recommendations.Evidence-Based Dentistry either publishes systematic reviews or summarizes reviews from other organizations, like the Cochrane Collaboration.

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