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Flossing and the Art of Scientific Investigation

Posted: December 12, 2016

A recent Associated Press report proclaimed that flossing isn’t necessary for good oral health because of the absence of “gold-standard” randomized controlled trials supporting its benefits.

Although the dental profession has already responded numerous times in the news media in defense of interdental cleaning, confusion continues to persist. Patients historically relied and trusted the experience of experts.  In today’s information-rich world where scientific evidence, whether good or bad, is readily available, they now expect that recommendations for treatment and health management will be rooted in science. When the news media informs them otherwise, it sows seeds of doubt about recommendations based on clinician experience. Clinicians often feel uncomfortable being put on the defensive and this can make for awkward communication.

How do we manage this conundrum?

A salient adage from the early years of evidence based medicine is “The Absence of Evidence is Not Evidence of Absence”.

A recent article published in the New York Times (Nov 25, 2016) does a very good job explaining this in lay public terms. I invite you to read “Flossing and the Art of Scientific Investigation” by Jamie Holmes (the author of “Nonsense: The Power of Not Knowing”):

http://www.nytimes.com/2016/11/25/opinion/sunday/flossing-and-the-art-of-scientific-investigation.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

It offers insight on how to communicate with patients about the value of good science and experience/judgment in a clear and concise manner. Happy flossing!

George K. Merijohn, DDS

San Francisco periodontist George K. Merijohn practiced 28 years and is associate professor in postdoctoral periodontics at UC San Francisco and U Washington. He is appointed special expert to the California Dental Board; serves as a consultant to dental schools, clinicians, and the legal profession; and is on the editorial board of the Journal of Evidence-Based Dental Practice. Dr. Merijohn leads seminars and workshops at major dental conferences and is published in peer-reviewed journals with articles on mucogingival clinical decision-making, risk assessment, and the evidence-based approach. More about George >