In light of a recent study published in the Journal of Exposure Science & Environmental Epidemiology, our Naperville cosmetic dentists, general dentists and specialists have been asked by a number of patients, is dental floss toxic? Well, according to the American Dental Association, the concern is unwarranted and we have to agree. The study in question wasn’t actually a flossing study but one that involved a small sample of women and their self-reported use of a wide variety of consumer products and foods. The buzz is due to the fact that some of the women with higher levels of one type of PFAS in their blood stream (PFAS are a broad class of man-made chemicals found in everything from non-stick cookware to stain-resistant carpets) used a certain type of dental floss. The media coverage of the study has given the impression that dental floss is toxic when, in reality, even the study’s authors noted more research is needed and that Glide Floss and similar products aren’t necessarily the underlying cause.
What are PFAS?
PFAS, an acronym for per- and polyfluoroalkyl substances, are a group of man-made chemicals used in a variety of industries worldwide. The chemicals can make certain materials grease- and water-proof so it’s not surprising they’re found in tons of consumer products, including non-stick cookware, stain-resistant carpet, furniture and clothing, flame-retardant fabrics, fast food wrappers, microwave popcorn bags, pizza boxes, cosmetics and more. People are also regularly exposed in day-to-day life by accidentally swallowing dust or dirt in the air that’s contaminated or drinking water that has PFAS in it.
PFAS don’t break down so they stay in the human body. In high levels, they have been correlated with certain health concerns, including low birth weights, fertility problems, ulcerative colitis, high cholesterol and hormonal issues, among others.
The Study Involving Dental Floss
The study wasn’t just a flossing study and floss was one small component of it. Researchers, led by the Silent Spring Institute and the Public Health Institute in Berkeley, California, took blood from 178 middle-aged women and tested it for evidence of PFAS. It was a retrospective study so they asked the women to recall how often they did a select group of behaviors that are associated with PFAS exposure, including cooking with non-stick cookware, eating food from certain containers, purchasing stain-resistant furniture and carpet and flossing.
The researchers found that the women who used Oral-B Glide floss had higher levels of a type of PFAS called PFHxS than the women who didn’t use the floss. However, drinking contaminated water, living in a house with stain-resistant furniture and eating a lot of fast food or takeout were also linked to higher levels of PFAS, which is where things get murky. The researchers tested Oral-B Glide Floss and several similar brands and found fluorine, a marker of PFAS, though the women who reported using it actually had elevated levels of a different PFAS, PFHxS.
So, Is Dental Floss Safe?
Yes, dental floss is safe and the American Dental Association (ADA) calls concerns “unwarranted.” The study had a number of shortcomings, most notably the small sample size and the fact that the behaviors like flossing with a certain brand of floss were self-reported and retrospective. Most of us can’t recall the exact products we used several years ago, so it needs to be taken with a grain of salt.
The ADA wrote in a recent statement on the issue, “The ADA Science Institute finds the data insufficient to support the conclusions presented in this research and associated media coverage.” The organization further went on to note that the U.S. Food and Drug Administration, which oversees the clearance of dental products that are marketed to the public, has not issued any warnings or restrictions on the use of dental floss. The ADA continued, “It is also important to bear in mind that this is a single study. Public health policy and safety decisions should be based on the collective weight of scientific evidence.”
Proctor & Gamble, the makers of Oral-B Glide Floss, released the following statement:
“We have confirmed none of the substances in the report are used in our dental floss. This study interviewed people about their self-reported use of a wide array of consumer products and foods, it was not focused on dental floss alone. In fact they did not demonstrate a correlation with use of dental floss to an increased presence of any of the reported substances. Our dental floss undergoes thorough safety testing and we stand behind the safety of all our products.
In the supplemental table in the study*, the dental floss data alone showed no correlation to these substances. It was only when trying to combine consumer products that they saw any correlations at all. Even the authors state, ‘Given the numerous sources of PFAS in everyday diets and environments it is difficult to pinpoint which behaviors contribute most significantly to PFAS exposure.’
What did the study measure? None of the substances in the study were measured in dental floss. They only looked for a generic marker that can also be found in many other materials.”
The Importance of Flossing
Daily flossing is essential for your oral health and the consequences of forgoing dental floss or other interdental cleaners is serious and well documented. When plaque builds up along the gum line and on the teeth, it can lead to tooth decay and gum disease. Flossing removes plaque from the places your toothbrush just can’t reach. Tooth decay can result in tooth loss and the need for costly dental procedures, while gum disease, also a leading cause of tooth loss, has been linked to health problems, including heart disease, stroke, diabetes and premature births. So continue to floss at least once daily and brush twice a day for two minutes each session.
At Naperville Dental Specialists, we wholeheartedly agree with the ADA’s position and don’t think one, small study should be a cause for alarm over dental floss. The benefits of flossing are so incredibly important for your oral health and overall health. If you have any questions about whether or not dental floss is safe or about flossing in general, schedule an appointment with a Naperville general dentist or specialist at our practice today!
