I have a DIY flossing study! For most of my life, I would have 2-3 cavities per dentist visit i.e. every 6 months. This was for years. My mouth is half filling at this point. I did the things, brushed regularly, prescription mouthwash, water pic, you name it. Didn't help. Notably most of my cavities were between teeth.
Then, I developed adhd for flossing and simply must floss after every meal. After every snack, after every sugary drink. Even at work, even on travel. Sometimes I floss 2 or 3 times between food. I brush less than once per day i.e. usually once per day but not always. I haven't had a single cavity in years. My last filling must have been 5 years ago or longer, I'm still doing regular visits.
I've never flossed in my life and brush my teeth exactly once per day. The couple of cavities I ever had were in not-fully-erupted wisdom teeth (toothbrush couldn't reach them). I've had dentists do all of the following: not comment on my flossing habits, tell me to floss more, tell me my tooth care was great.
My hypothesis: some people are more prone to cavities than others; probably brushing and flossing improve one's tooth health, but for lucky people the baseline is good enough that it doesn't require much maintenance to avoid cavities. Dentists can only tell the absolute health of your teeth, not how much maintenance it took to get them to that level.
I started flossing every night about ten years ago, after I developed a problem with my gums. Within a fairly short period of time, I noticed a significant improvement in gum health. In the past, whenever I'd get my teeth cleaned at the dentist's office, I'd have a fair amount of bleeding. I also had occasional bleeding just from brushing my teeth. After I started flossing, I now have very little bleeding during teeth cleanings, and I never see blood when I brush my teeth. My observation is confounded by the fact that I started using a Waterpik device at the same time I began the daily flossing, so I don't know if the benefit came from the floss, the Waterpik, or both.
I don't know what to make of the bleeding thing. Flossing seems to toughen up the gums so that they don't bleed, but is that a good thing? You could make any part of your skin more resistant to bleeding by rubbing it until it forms a callus, but I don't know if you'd actually be better off.
I think that inflamed gums are more susceptible to mechanical damage that leads to bleeding. What's probably happening is that removing some of the plaque and food debris leads to reduced inflammation. I don't have time to do a literature search, so I don't know if my intuitions are supported by the research.
My original reason for starting my daily flossing and Waterpiking was that I developed a pocket between two of my molars. Food would get stuck in the pocket, and I'd suffer considerable pain until I removed the food with a Waterpik (flossing didn't work for this purpose). It took several weeks for the pocket to heal. I now floss and Waterpik every night, religiously (similar to Keith up above). I literally haven't missed a day since I started, even on nights when I get home late and just want to go to bed, and even through two bouts of Covid. I haven't had a pocket since then. Also, I used to sometimes wake up with a bad taste in my mouth, and that doesn't happen anymore.
Generally good dental health - never had any trouble with cavities, except once when I went several years without seeing a dentist after moving. (I did brush the whole time.)
I go to the dentist regularly now, and did have trouble with bleeding gums that cleared up after I started flossing. (Now I'm slacking off more, though...)
Whenever I see mention of ether, I immediately think of this quote from "Fear and Loathing in Las Vegas", by Dr. Hunter S. Thompson:
The trunk of the car looked like a mobile police narcotics lab. We had two bags of grass, seventy-five pellets of mescaline, five sheets of high-powered blotter acid, a saltshaker half full of cocaine, and a whole galaxy of multi-colored uppers, downers, screamers, laughers... and also a quart of tequila, a quart of rum, a case of Budweiser, a pint of raw ether and two dozen amyls.
[...]
The only thing that really worried me was the ether. There is nothing in the world more helpless and irresponsible and depraved than a man in the depths of an ether binge. And I knew we'd get into that rotten stuff pretty soon. Probably at the next gas station.
You/your readers may be interested in a book I read not too long ago called Junk Science and the American Criminal Justice System by M. Chris Fabricant. It sounds like some of the knowledge in dentistry is similar to what Fabricant describes when talking about hair/fiber analysis, bite mark analysis, and other techniques. Basically these are totally bunk forensic techniques where DNA testing has shown "expert" testimony that put someone away based on comparing hair samples found some of the samples they said matched the perpetrators were from dogs and others were fibers from carpets or just different humans.
However, a lot of these scientific seeming practices were the result of apprenticeship and teaching from the pioneers of the techniques or other experts. It took decades for people to do real controlled trials and then longer for the new understanding to be used to discredit those supposed experts. But courts still accept some unreliable forms of evidence based on this expert testimony.
Re flossing: I find dentists claims about flossing very easy to believe. I never flossed until about age 30, then my gums started bleeding when I brushed. Dentist told me I should start flossing, provided a plausible mechanistic justification. I started flossing, soon the bleeding stopped. If I stop for a while, the bleeding eventually comes back.
Maybe it's more complicated as a "public health" topic but for me personally "does flossing improve oral health" is akin to "does exercise improve fitness".
I have done a non-randomized study on flossing with three subjects, testing the absence of flossing and the presence of bad breath. Results in 100% of subjects show that pieces of food rotting while stuck between teeth impact mouth smell (not in a good way). Study did not account for possible differences in tooth spacing that might render subjects more or less likely to trap food.
"The phrase “publish or perish” has been around since at least 1942, maybe even earlier."
True, but it had a different meaning back then. How did we get from "Publish or your findings will perish!" to "Keep publishing or you will perish (as a professional)!" ? (It's a rhetorical question.)
A friend of mine takes care of her teeth ok. She only brushes once a day, IN THE MORNING, probably after snacking before bed. She only goes to the dentist for a cleaning every 2-3 YEARS and has never had a cavity.
Me, I'm a good flosser, not quite ocd like Keith, but I kinda like to relieve driving boredom by using those little D-shaped flossers. Every time I go to the dentist every 6 months or so, they say I'm doing a good job and it seems like I have less stuff to scrape off. (I love my dentist by the way, because she'll watch the potential cavities instead of Drill baby drill right off the bat.) Despite my flossing regime, I have a cavity every 2 years or so. And I have a lot of gum recession which I've been expecting because my mom had it. I feel like I've been led to believe my teeth would be perfect if I flossed. I also believed for a while that my zits would be gone as soon as I turned 18.
So obviously there is a huge GENETIC component. My next questions are how long is it really going to take for my teeth to fall out of my head :-/
My dental experiment is to stop using toothpaste, which I hypothesized was destroying the oral microbiome. Two years in--no cavities, greatly reduced plaque, 15 lbs weight loss, and 2 inches off the waist. (Not sure that this is entirely the result of not using toothpaste.) I would like to see some research done on this.
There are more miracle cures for hiccups!: A Swedish surgeon claims that stimulating the tongue root of a patient to trigger the gag reflex effectively ends hiccups in all patients. This includes patients with long-lasting severe hiccups. Apparently this is a trick-of-the-trade known by many (Swedish?) surgeons that isn't published or studied much. I initially though the link would go to this cure, happy to see that there are others. Link to article (in Swedish): https://lakartidningen.se/wp-content/uploads/OldPdfFiles/1999/19866.pdf
Thanks for the link to the history of mkultra, it had details that were new to me. It lacks any mention of the significant cultural side effects. 2 of the people who volunteered (for the money) and got dosed with LSD were the author Ken Kesey and the poet/song lyricist Robert Hunter. Kesey in particular decided to have fun with it, and so ensued the Merry Pranksters, the Electric Kool-Aid Acid Tests, the "summer of love", hippies, be-ins, the Grateful Dead, Jefferson Airplane and the other San Francisco bands, underground comix, the Whole Earth Catalogue, etc. culminating in Woodstock and Altamont. Some irony there.
On the matter of systematic reviews and meta-analyses: As an expert in systematic review methodology, I can attest that the problem isn't just with junk research being incorporated into reviews; the problem is often also with the reviews being junk themselves. It's disturbingly difficult to find a well-performed and reported systematic review - most rank as little more than a half-hearted lit review that some researcher wanted to published so they shined it up and called it systematic.
Re fraud (2/6): Isn’t AI the answer? It can handle all the volume a human can send to it and correct all “honest mistakes” (ahem) before a paper is given its stamp of approval.
Thanks for all of this. Especially loved the toaster cleaning blog and the cancer moonshot comment. A thought on the blog competition: since the deadline for submissions has passed, shouldn't everyone who entered be able to publish their post now?
> Atlantic: The cure for hiccups exists and it's free! But nobody knows because there's no money to be made in disseminating it!
> Puts article behind paywall
Genius
I have a DIY flossing study! For most of my life, I would have 2-3 cavities per dentist visit i.e. every 6 months. This was for years. My mouth is half filling at this point. I did the things, brushed regularly, prescription mouthwash, water pic, you name it. Didn't help. Notably most of my cavities were between teeth.
Then, I developed adhd for flossing and simply must floss after every meal. After every snack, after every sugary drink. Even at work, even on travel. Sometimes I floss 2 or 3 times between food. I brush less than once per day i.e. usually once per day but not always. I haven't had a single cavity in years. My last filling must have been 5 years ago or longer, I'm still doing regular visits.
I've never flossed in my life and brush my teeth exactly once per day. The couple of cavities I ever had were in not-fully-erupted wisdom teeth (toothbrush couldn't reach them). I've had dentists do all of the following: not comment on my flossing habits, tell me to floss more, tell me my tooth care was great.
My hypothesis: some people are more prone to cavities than others; probably brushing and flossing improve one's tooth health, but for lucky people the baseline is good enough that it doesn't require much maintenance to avoid cavities. Dentists can only tell the absolute health of your teeth, not how much maintenance it took to get them to that level.
Agree totally. The people who think flossing doesn't matter probably have strong enamel and it doesn't matter what their dental hygiene is like.
I started flossing every night about ten years ago, after I developed a problem with my gums. Within a fairly short period of time, I noticed a significant improvement in gum health. In the past, whenever I'd get my teeth cleaned at the dentist's office, I'd have a fair amount of bleeding. I also had occasional bleeding just from brushing my teeth. After I started flossing, I now have very little bleeding during teeth cleanings, and I never see blood when I brush my teeth. My observation is confounded by the fact that I started using a Waterpik device at the same time I began the daily flossing, so I don't know if the benefit came from the floss, the Waterpik, or both.
I don't know what to make of the bleeding thing. Flossing seems to toughen up the gums so that they don't bleed, but is that a good thing? You could make any part of your skin more resistant to bleeding by rubbing it until it forms a callus, but I don't know if you'd actually be better off.
I think that inflamed gums are more susceptible to mechanical damage that leads to bleeding. What's probably happening is that removing some of the plaque and food debris leads to reduced inflammation. I don't have time to do a literature search, so I don't know if my intuitions are supported by the research.
My original reason for starting my daily flossing and Waterpiking was that I developed a pocket between two of my molars. Food would get stuck in the pocket, and I'd suffer considerable pain until I removed the food with a Waterpik (flossing didn't work for this purpose). It took several weeks for the pocket to heal. I now floss and Waterpik every night, religiously (similar to Keith up above). I literally haven't missed a day since I started, even on nights when I get home late and just want to go to bed, and even through two bouts of Covid. I haven't had a pocket since then. Also, I used to sometimes wake up with a bad taste in my mouth, and that doesn't happen anymore.
I had a similar experience.
Generally good dental health - never had any trouble with cavities, except once when I went several years without seeing a dentist after moving. (I did brush the whole time.)
I go to the dentist regularly now, and did have trouble with bleeding gums that cleared up after I started flossing. (Now I'm slacking off more, though...)
I had really bad bleeding which resolved after cutting out Legumes.
Whenever I see mention of ether, I immediately think of this quote from "Fear and Loathing in Las Vegas", by Dr. Hunter S. Thompson:
The trunk of the car looked like a mobile police narcotics lab. We had two bags of grass, seventy-five pellets of mescaline, five sheets of high-powered blotter acid, a saltshaker half full of cocaine, and a whole galaxy of multi-colored uppers, downers, screamers, laughers... and also a quart of tequila, a quart of rum, a case of Budweiser, a pint of raw ether and two dozen amyls.
[...]
The only thing that really worried me was the ether. There is nothing in the world more helpless and irresponsible and depraved than a man in the depths of an ether binge. And I knew we'd get into that rotten stuff pretty soon. Probably at the next gas station.
You/your readers may be interested in a book I read not too long ago called Junk Science and the American Criminal Justice System by M. Chris Fabricant. It sounds like some of the knowledge in dentistry is similar to what Fabricant describes when talking about hair/fiber analysis, bite mark analysis, and other techniques. Basically these are totally bunk forensic techniques where DNA testing has shown "expert" testimony that put someone away based on comparing hair samples found some of the samples they said matched the perpetrators were from dogs and others were fibers from carpets or just different humans.
However, a lot of these scientific seeming practices were the result of apprenticeship and teaching from the pioneers of the techniques or other experts. It took decades for people to do real controlled trials and then longer for the new understanding to be used to discredit those supposed experts. But courts still accept some unreliable forms of evidence based on this expert testimony.
Thanks for this recommendation! I'll order this one soon.
Re flossing: I find dentists claims about flossing very easy to believe. I never flossed until about age 30, then my gums started bleeding when I brushed. Dentist told me I should start flossing, provided a plausible mechanistic justification. I started flossing, soon the bleeding stopped. If I stop for a while, the bleeding eventually comes back.
Maybe it's more complicated as a "public health" topic but for me personally "does flossing improve oral health" is akin to "does exercise improve fitness".
I have done a non-randomized study on flossing with three subjects, testing the absence of flossing and the presence of bad breath. Results in 100% of subjects show that pieces of food rotting while stuck between teeth impact mouth smell (not in a good way). Study did not account for possible differences in tooth spacing that might render subjects more or less likely to trap food.
"The phrase “publish or perish” has been around since at least 1942, maybe even earlier."
True, but it had a different meaning back then. How did we get from "Publish or your findings will perish!" to "Keep publishing or you will perish (as a professional)!" ? (It's a rhetorical question.)
A friend of mine takes care of her teeth ok. She only brushes once a day, IN THE MORNING, probably after snacking before bed. She only goes to the dentist for a cleaning every 2-3 YEARS and has never had a cavity.
Me, I'm a good flosser, not quite ocd like Keith, but I kinda like to relieve driving boredom by using those little D-shaped flossers. Every time I go to the dentist every 6 months or so, they say I'm doing a good job and it seems like I have less stuff to scrape off. (I love my dentist by the way, because she'll watch the potential cavities instead of Drill baby drill right off the bat.) Despite my flossing regime, I have a cavity every 2 years or so. And I have a lot of gum recession which I've been expecting because my mom had it. I feel like I've been led to believe my teeth would be perfect if I flossed. I also believed for a while that my zits would be gone as soon as I turned 18.
So obviously there is a huge GENETIC component. My next questions are how long is it really going to take for my teeth to fall out of my head :-/
My dental experiment is to stop using toothpaste, which I hypothesized was destroying the oral microbiome. Two years in--no cavities, greatly reduced plaque, 15 lbs weight loss, and 2 inches off the waist. (Not sure that this is entirely the result of not using toothpaste.) I would like to see some research done on this.
There are more miracle cures for hiccups!: A Swedish surgeon claims that stimulating the tongue root of a patient to trigger the gag reflex effectively ends hiccups in all patients. This includes patients with long-lasting severe hiccups. Apparently this is a trick-of-the-trade known by many (Swedish?) surgeons that isn't published or studied much. I initially though the link would go to this cure, happy to see that there are others. Link to article (in Swedish): https://lakartidningen.se/wp-content/uploads/OldPdfFiles/1999/19866.pdf
Whenever I see mention of OnStar I immediately think of the ubiquitous commercials of the nineties, starring Batman. https://www.youtube.com/watch?v=u9RlstqISQw
Thanks for the link to the history of mkultra, it had details that were new to me. It lacks any mention of the significant cultural side effects. 2 of the people who volunteered (for the money) and got dosed with LSD were the author Ken Kesey and the poet/song lyricist Robert Hunter. Kesey in particular decided to have fun with it, and so ensued the Merry Pranksters, the Electric Kool-Aid Acid Tests, the "summer of love", hippies, be-ins, the Grateful Dead, Jefferson Airplane and the other San Francisco bands, underground comix, the Whole Earth Catalogue, etc. culminating in Woodstock and Altamont. Some irony there.
On the matter of systematic reviews and meta-analyses: As an expert in systematic review methodology, I can attest that the problem isn't just with junk research being incorporated into reviews; the problem is often also with the reviews being junk themselves. It's disturbingly difficult to find a well-performed and reported systematic review - most rank as little more than a half-hearted lit review that some researcher wanted to published so they shined it up and called it systematic.
Re fraud (2/6): Isn’t AI the answer? It can handle all the volume a human can send to it and correct all “honest mistakes” (ahem) before a paper is given its stamp of approval.
Thanks for all of this. Especially loved the toaster cleaning blog and the cancer moonshot comment. A thought on the blog competition: since the deadline for submissions has passed, shouldn't everyone who entered be able to publish their post now?
Thanks for sharing my article! I actually wanted to submit to your blog post contest and then forgot