Don’t brush off flossing

The conventional wisdom: Flossing is the best way to get rid of the bits of food and that whitish, smelly stuff that collects in the tiny furrows between your teeth and your gums. The white film is the "plaque buildup" they talk about so much on toothpaste commercials, although brushing actually does a poor job of removing it from between your teeth. Plaque is a biofilm — sticky collections of bacteria, their excretions, and other substances that form into an impervious little microbial ecosystem.

Recent research has sowed a little doubt about flossing. In 2002, Harvard researchers published a study of the oral hygiene practices of health care professionals and found that regular flossers were just as likely as nonflossers to have periodontitis (advanced gum disease). A year later, a study published in the Journal of the American Dental Association reported that using mouthwash twice a day was just as effective as flossing at reducing plaque and gingivitis.

But flossing scofflaws don't get off the hook that easily. Most studies still say flossing has oral health benefits. The study comparing mouthwash with flossing was paid for by Pfizer, which makes Listerine. And the American Dental Association points out that the study — and another one that was published earlier — didn't examine the effects on tooth decay and periodontitis.

Flossing also has a federal judge on its side. In January 2005, U.S. District Court Judge Denny Chin sided with a subsidiary of Johnson & Johnson that makes dental floss and ordered Pfizer to stop an ad campaign for Listerine that claimed mouthwash was as effective as flossing. "Dentists and hygienists have been telling their patients for decades to floss daily," wrote the judge, who we suspect dutifully flosses. "They have been doing so for good reason. The benefits of flossing are real —they are not a myth."

Mouthwash isn't the only competition these days. BrushPicks are springy, plastic toothpicks with a slender, serrated end that is supposed to be good for scraping away plaque. A 2002 study showed that they worked better than Glide, a high-tech floss. When we used them, we found it difficult to reach between the molars. But flossing is a chore, and it was fun to poke around with a toothpick for a change.

There are also interdental brushes that look like tiny, bristled bottle cleaners. Most involve buying a toothbrush-like holder for about $3 and replacement packs of the brushes for another $3. Fifty meters of dental floss costs about $3, so the brushes are the more expensive way to go. We tried a travel version that didn't require a separate holder. Tiny as the brushes are, we still found it difficult to squeeze them between our teeth. Using them was also a little messy. Maybe we just need some practice.