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Your dentist's advice may prove to be toothless
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It's not just the flossing. Or the fluoride. A lot of what your dentist has been telling you to do over the years is looking, well, toothless, according to new reports that contradict common advice. - photo by Jennifer Graham
It's not just flossing. Or the fluoride. A lot of what your dentist has been telling you to do over the years is looking, well, toothless, according to a new report that contradicts commonly given advice.

Writing for The New York Times, Dr. Aaron E. Carroll debunked everything you thought you knew about your teeth, including the need for yearly X-rays and biannual visits to the dentist.

Carroll isn't a dentist; he's a professor of pediatrics at Indiana University School of Medicine and a researcher on health policy who has published several books about health myths. In The Times, he turned a critical eye on why his teeth are astonishingly excellent (as Donald Trump's doctor might say) despite haphazard care, while his wife has a mouthful of fillings even though she "does all the things youre supposed to do, and then some."

"Clearly, the stuff were doing might not make as much of a difference as we think," Carroll wrote.

The unraveling began last month when a widely publicized study said that there is no good evidence for flossing.

As Dr. Timothy Levine, an orthodontist, explained Aug. 12 in The Washington Post, dental floss was invented in the 1800s, and its efficacy has never been proven. Instead, our dentists' recommendations to floss daily is "based on assumptions" that, it should be noted, were made during an era in which everyone expected their teeth to fall out eventually.

Meanwhile, fluoride, once considered the gold standard of maintaining healthy teeth, has been in freefall in public opinion, and many toothpastes now brag that they are fluoride-free.

Carroll, however, believes that brushing twice a day with fluoride toothpaste and a power toothbrush is one piece of advice that makes sense. Everything else, not so much. Example:

You run the risk of an annoyed dentist, but if you're generally in good dental health, you can occasionally decline X-rays, even though your dental insurance probably covers them once a year, Carroll said.

The American Dental Association says adults only need X-rays every two to three years if there is no outward sign of disease or decay, and why expose yourself to even low levels of radiation unnecessarily?

The ADA says children and adolescents, however, need them more often: every 12 to 24 months for children; 18 to 36 months for adolescents.

Another bit of common advice Carroll challenges is the need to have your teeth professionally cleaned every six months. He cited a 2005 report that analyzed eight studies that purported to learn whether routine cleanings made a significant difference in plaque, tooth loss and gingivitis, among other conditions. The findings, however, were mixed and had a "high risk of bias."

In his conclusions, Carroll noted a theory of dental health that is increasingly gaining traction: that in addition to genetics and hygiene, what you eat can affect the health of your teeth.

He also warned that parents can pass cavity-causing bacteria to their children by sharing silverware.

That's something to think about the next time you sit down to eat as a family along with recent news that archeologists have found food particles trapped in the fossilized teeth of nine people who lived in the Balkans 8,600 years ago.

In their defense, the toothbrush as we know it today wasn't invented until 1938, according to the Library of Congress.
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