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Kressin NR, Boehmer U et al. J Dent Res 2003; 82: 223–227

In the US, the ADA and the Surgeon General have recommended that individuals brush twice and floss once daily, and have regular prophylaxis visits. The desired outcome is to maximize tooth retention, but there is little research on whether this is achieved.

This study considered data from 736 dentate men (mean age 48 yrs, range 28–80) examined 3-yearly from 1969. The first 4 cycles (13 yrs) were examined as predictors of the clinical data over 26 yrs. Initially, participants had a mean of 24 teeth, 72% had education beyond high school, 20% smoked, 55% brushed once and 43% twice daily, 38% flossed, 85% had regular prophylaxis treatment, and 8% had a denture.

Consistently good oral health behaviour over the 13 yrs was related to less tooth loss. Of a mean 24 teeth per subject, 13% were lost over the study period. A significantly increased relative risk for tooth loss occurred with smoking (1.92 for a pack per day), and reduced risk with brushing (0.51), brushing & flossing (0.44), and brushing, flossing & prophylaxis (0.33).