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Hujoel PP, Cunha-Cruz et al. J Dent Res 2006; 85: 298–305

Although oral hygiene is not considered as important as diet control in preventing caries, there have been flossing studies reporting a significant reduction in caries. This systematic review identified 6 trials where the caries status of subjects receiving flossing in 3 ways was compared with that of controls.

Problems identified in individual studies included poor reporting, a high risk of bias and a lack of blinding to outcome. Further statistical adjustment was necessary to correct other factors not taken into account in certain studies. The effect of fluoride was also difficult to elucidate. In 4 studies, there were no significant caries differences between flossing and control groups.

The authors concluded that professional flossing performed on school days for 1.7 years reduced the risk of proximal caries by 40% in children with low fluoride exposure, but that large studies will be needed to identify any more general effect of flossing on caries.