Dental Flossing and Oral Health Outcomes in Adults Over A 10-Year Period: A Cohort Study.

Authors

Icaro Santiago de Aquino, Adriano de Aguiar Filgueira, Mariana Ramalho de Farias, Rodrigo Otavio Rego, Luiz Roberto Augusto Noro, Ana Karine Macedo Teixeira

Published in

International journal of dental hygiene. Oct 01, 2026. Epub Oct 01, 2026.

Abstract

To analyse the effect of flossing on dental caries and periodontal conditions in adults from Sobral, Ceará, Brazil over 10 years.
This was a prospective cohort. The sample was 260 adults (aged 27-31) who participated in 2012 and 2022 follow-ups. The outcomes analysed were dental caries, tooth loss due to caries, gingival bleeding, dental calculus and periodontal pockets. The trajectory of flossing between 2012 and 2022 was analysed using three groups: always flossed, sporadically flossed and never flossed. Negative binomial regression was employed to conduct a longitudinal analysis and estimate the relative risk of tooth decay, tooth loss and periodontal conditions in adulthood, adjusting for gender, family income and toothbrushing frequency.
53.8% of the participants reported never having used dental floss, whereas 25.4% of them have used it sporadically and 20.8% have always used it. The average incidence of decayed teeth was 4.66 (SD = 3.33). Adults who did not floss in 2022 had a higher prevalence of untreated caries, bleeding gums and dental calculus. The final longitudinal model revealed that never having flossed was a risk factor for the incidence of tooth loss (RR = 1.07 [95% CI 1.03-1.12]), gingival bleeding (RR = 1.36 [95% CI 1.09-1.70]) and dental calculus (RR = 1.32 [95% CI 1.04-1.67]). Individuals who sporadically flossed also exhibited a risk of new cases of tooth loss (RR = 1.13 [95% CI 1.04-1.22]).
Young adults who have never flossed for 10 years are at greater risk of oral health problems. Flossing complementary to toothbrushing is recommended as a measure to prevent and control oral health problems such as caries and periodontal conditions.

PMID:
42823829
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.

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