Brushing cleans the surfaces you can see. The spaces between your teeth, where most gum disease and much of the decay begins, need their own habit. About two out of three American adults don't have it. These articles cover what the evidence says, honestly.
Last reviewed
The government's own health surveys keep finding the same thing: roughly a third of US adults report flossing every day. And because it's self-reported, the real number is likely lower.
CDC NHANES · Fleming 2018 · Liang & Aris 2024Surveys consistently find most people say they'd floss more if it were simply easier. What the habit research says about making that true.
Survey literature · qualitativeMany people stop flossing the moment they see blood, but bleeding gums are often one of the earliest signs of gum disease, and the bleeding usually fades within about a week of consistent flossing.
ADA · NIDCR/NIHAn NIH-funded study followed older adults for five years: flossers lost about one tooth, non-flossers about four. Association, not proof. But a striking, conflict-free finding.
Marchesan · J Dent Res 2020In large national survey data, adults who clean between their teeth regularly have measurably less gum disease, and the most frequent cleaners have the least severe disease.
Marchesan · J Dent Res 2018Cochrane, the gold standard of evidence review, finds that cleaning between the teeth reduces gum inflammation. The certainty is modest, and we explain exactly what that means.
Cochrane CD012018A peer-reviewed review estimates brushing on its own removes only up to about 60% of plaque. The rest sits between the teeth: exactly where interproximal decay and gum disease begin.
Ng & Lim · Dentistry Journal 2019No winner-takes-all marketing claims: just what independent studies show about each tool, and why the best one is the one you'll actually use.
Independent trials onlyHardware changes the job. Where string floss physically can't reach, studies show a directed water stream helps control gum bleeding around implants and brackets.
2025 systematic review + RCTAmerica buys roughly a dozen powered toothbrushes for every flossing device. That lopsided ratio helps explain why gum disease stays so common even as brushing improved.
First-party sales data + CDC NHANES