flossing -- very little evidence?

9.28: news.health/dental/flossing/very little evidence?:
summary:
. flossing has not been shown to prevent
severe periodontal disease, surprisingly.
nevertheless, people who brush and floss regularly
have less gum bleeding compared to toothbrushing alone.
There is poor evidence from twelve studies that
flossing in addition to toothbrushing
reduces gingivitis compared to toothbrushing alone.
. what to do if tooth erosion cuts your floss?
interdental brushes might reduce gingivitis,
(again, the evidence is poor quality).

nytimes 2016/08/03:
. latest dietary guidelines for Americans, issued by the
Departments of Agriculture and Health and Human Services,
quietly dropped any mention of flossing
without notice. This week, The Associated Press reported
that officials had never researched the effectiveness of regular flossing,
as required, before cajoling Americans to do it.
. the American Academy of Periodontology acknowledged that
most of the current evidence fell short because
researchers had not been able to include enough participants
or “examine gum health over a significant amount of time.”

nytimes`Aaron Carroll 2016/08/30:
. anyone ever told you to use an interdental brush
to get at the plaque between your teeth? In 2015,
Evidence-Based Dentistry summarized a Cochrane Review
of seven randomized controlled trials
looking at how interdental brushing in addition to tooth brushing
compared with toothbrushing alone or toothbrushing with flossing.
Almost no long-term benefits have been proven

cochrane`flossing:
There is poor evidence from twelve studies that
flossing in addition to toothbrushing
reduces gingivitis compared to toothbrushing alone.
This review looks at the added benefit of dental flossing,
in people who brush their teeth regularly,
for preventing gum disease and tooth decay.
. Twelve trials were included in this review which reported
data on two outcomes (dental plaque and gum disease).
Trials were of poor quality
and conclusions must be viewed as unreliable.
The review showed that people who brush and floss regularly
have less gum bleeding compared to toothbrushing alone.
There was no information on other measurements
such as tooth decay because the trials were not long enough
and detecting early stage decay between teeth is difficult.

cochrane`interdental brushing:
. some very low-quality evidence that
using interdental brushes plus toothbrushing
is more beneficial than toothbrushing alone
for plaque and gingivitis at one month.
There is also low-quality evidence that
using interdental brushes reduces gingivitis (gum inflammation)
by 52% when compared with flossing at one month.

examples of interdentals:
GUM proxabrush, GUM Soft-Picks,
DenTek Interdental (extra tight)