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How Many Americans Floss Their Teeth?

A new analysis shows most of us are ignoring our dentists’ advice.

Americans can now be scientifically divided into three categories: Those who floss daily, those who never floss and those who fall somewhere in between.

The first nationally representative analysis designed to determine how many people floss their teeth found that those who floss daily amount to 30 percent of the population. Just over 37 percent report less than daily flossing; slightly over 32 percent say they never floss.

Lead author Duong T. Nguyen, a medical epidemiologist, said the idea for the study hit him one day when he was rummaging through his house looking for dental floss.

“I wondered how many people really do [floss],” says Nguyen, of the Centers for Disease Control and Prevention. A little checking revealed that “nobody had ever looked at this before,” at least in a rigorous, scientifically valid analysis, he says.

Nguyen was in an ideal position to tackle the question. A member of the CDC’s Epidemic Intelligence Service (EIS) – the agency’s training program for disease detectives – he was assigned to the National Health and Nutrition Examination Survey (NHANES), a representative look at the nation’s health habits based on interviews and physical examinations of 5,000 people a year. One section of the survey asked about flossing.

Done properly, flossing removes food particles that stick to teeth creating colonies of bacteria that promote inflammation and gum disease. Over time, these colonies, called plaque, harden into tarter and wear away at gums and bone, eventually causing tooth loss.

The researchers examined NHANES data from 9,056 US adults, age 30 and up, who participated from 2009 to 2012. Nguyen and his colleagues parsed their answers by age, sex, race and a ratio of family income and poverty level.

Among the findings:

  • Males (39 percent) were more like to report never flossing than females (27 percent).
  • People 75 or older (45 percent) were more likely to report never flossing than those age 30 to 44 (31 percent).
  • Non-Hispanic blacks (40 percent) and Hispanics (38 percent) were more likely to report never flossing than non-Hispanic white adults (30 percent).
  • Low-income participants (49 percent) were more likely to report never flossing than those in higher income brackets (28 percent).

Dr. Matthew Messina, a Cleveland dentist and consumer advisor for the American Dental Association, says most dentists would guess that the percentage of daily flossers is less than 30 percent, maybe as low as 10 percent. That two-thirds of patients are flossing daily or regularly is probably good news, he says.

Even better news is that there’s now sufficient data on flossing practices to inform discussions about prevention and education. “It’s never been looked at to this extent,” Messina says. “It’s nice to have a study that actually looks at [flossing] and gives us a big enough sample to work with.”

“What it tells me, as a medical provider, is that we need to increase education,” says author Nguyen, who reported the findings Monday in Atlanta at the agency’s 65th EIS Conference. “Something as simple as flossing is, to a lot of people, a bane,” he says. “They don’t want to do it. Yet, in the long run it can be so beneficial – it can prevent tooth loss and everything that comes with it.”


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