Interdental Devices. Weak Effectiveness Detected from Weak Studies

Recently the Associated Press published a report detailing their requests to the US departments of Health and Human Services and Agriculture for information regarding the effectiveness of flossing.[1] They found only weak evidence, and when the federal government issued their updated dietary guidelines flossing was no longer recommended.

An overview (meta-review) from 2015 was cited, which evaluated various interdental devices with respect to protecting against plaque and gum disease.[2] The effects of using a device and brushing, versus brushing alone, are small, but mainly in a positive direction. Also interdental devices were superior to floss when the two were compared head-to-head, but again the difference was of small magnitude. The quality of the trials in the six meta-analyses included in the overview was not very high on average. We do not know how good compliance with use of devices was in the intervention group across studies, nor the extent to which the control group abstained from use of devices. Interviewed on radio BBC Hereford and Worcester, the CLAHRC WM Director opined that he would continue to use interdental devices, despite their apparent nugatory effects, for reasons of taste and aesthetics, just as he shampoos his hair regularly even though it will not prevent him from going grey on top.

— Richard Lilford, CLAHRC WM Director


  1. Donn J. Medical Benefits of Dental Floss Unproven. Associated Press. 2 August 2016.
  2. Sälzer S, Slot DE, Van der Weijden FA, Dörfer CE. Efficacy of inter-dental mechanical plaque control in managing gingivitis–a meta-review. J Clin Periodontol. 2015; 42(s16): s92-105.

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