So out of all the patients that HONESTLY floss everyday.... how many are doing it effectively? I'm sure we were all questioned by at least one patient when the AP published the article by Jeff Donn titled "Medical benefits of dental floss unproven". As if we don't have a hard enough time convincing people that they should, this guy's article goes viral.
I don't know about you- but this article made me MAD. Of course there are little studies that prove the efficacy of flossing. There aren't many studies to prove that it is effective because no one wants to waste the time and money to study something that is inexpensive and causes no harm (if done right) to the patient.
That being said- flossing CAN be ineffective if the patient isn't doing it right. There is a correct technique and it's not always easy for everyone to do. Dexterity issues, difficult anatomy, and complex ortho appliances can make it very difficult to use traditional floss. But we all know how important it is to use SOMETHING interdentally.
I try not to ask a patient "do you floss?". Most of the time they answer defensively - even if they DO floss regularly. Keeping a discussion open and "judgement free" is important in home care instruction. I usually start the conversation by asking the patient what their routine is like in terms of taking care of their teeth. Most people start by saying they brush twice a day.... and those that actually clean interdentally will tell me what they use. Floss doesn't work for everyone, and not all floss is created equal. When a patient says "my teeth are too tight for floss" - I like to suggest starting with something slippery and easy to use- like Glide. If someone is flossing daily, I like waxed or scrubbing floss- something with a texture to it. For those with larger embrasures and artificial contacts (crowns) I like proxabrushes or softpicks. For kids- floss picks are my go to. Basically, I really try and find the best aide for each individual patient. I know I never listened when my hygienist repeatedly TOLD me to floss - and no one likes to be lectured!😵