Hi Dr. Phillips,

I did finally buy your book on Amazon (the electronic version), and it answered a lot of questions. As a scientist, I personally would have appreciated a more technical approach, but I understand that you were writing for a lay audience. Thank you for writing such a clear, concise book. My teeth have never looked better, though I still harbor some white spots as a result of bad hygiene when I wore braces. I’m cautiously exploring some of the newer technologies for this reason, hoping to get some subsurface remineralization.

When reading about your thoughts on flossing, I was incredulous that no clinical trials had ever been done. I suppose it just seems so obvious that it was grandfathered in from before the time of evidence-based medicine? This review: http://jdr.sagepub.com/content/85/4/298.abstract does mention one study that suggests that daily professional flossing does significantly reduce caries… but you really can’t get any more unrealistic as far as public health measures go. But what about gingivitis? Is there any evidence for this, because my purely personal experience seems to suggest so. It can be so frustrating to give up your assumptions, especially when they’re trumpeted by every dental professional you’ve ever met. This Cochrane review http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008829.pub2/abstract suggests an incredibly weak anti-gingivitis action beyond brushing.. but it’s from only one study, which the panel describes as “very unreliable”. What in the world is going on? Is flossing really so pointless? What about the little pieces of food it sometimes brings out?

And the National Flossing Council? Seriously, there’s a flossing lobby!? As if health misinformation isn’t garbled enough! In the Listerine vs. Flossing court ruling, the judge apparently said that “substantial evidence” backed the use of floss… where is this evidence?

I was also incredulous about your suggestion that MI Paste and Recaldent are hardly better than milk powder. I was sure you were exaggerating. But after reading the relevant studies and patents, I was stunned to see how right you were. In fact, there is is no doubt in my mind that low lactose hard cheeses are just as effective as CPP-ACP products, especially considering the taste and price – which translates into many more exposures and much better patient compliance.

Thanks again for being a public health crusader.

– J

Dear J: 
Thanks so much for your message – INTERESTING isn’t it!

We have to consider even perfect flossing and brushing can only remove 40% of plaque ( because the remainder is on mucous membranes and in saliva) and that plaque re-grows quickly. Regular consumption of xylitol over a period of 6 months removes 98% of plaque and promotes the formation of a healthy Pellicle over teeth – and we see that pellicle is a necessary defense against infection and also necessary for tooth remineralization. Your niece should try some of the various flavors of xylitol ( Zellies fruit mints are delicious!)

You will not get gingivitis if you don’t have plaque.
It is OK to floss out bits of food with floss – but be careful not to damage your gums – flossing!

You will not get periodontal pathogens lodging in periodontal pockets – unless your gums are first damaged by gingivitis. In other words, no plaque- no gingivitis – no cavities – no periodontal disease.

It is sad but true: Follow the money.
I am glad you noticed that there is a flossing lobby – I could never find the end of the money trail for this – but I assume the ADA.

Fluoride of course ends in the hands of ALCOA, Proctor and Gamble and Coca-Cola ( all sponsors of the ADA). Also, the Intellectual Property for MI paste is owned by the Paffenbarger Institute – the ADA Research arm ( which explains why they are so excited about MI paste)!!http://ada.org/prc.aspx

I hope I answered all your questions.

More information can be found on this topic and more at: www.drellie.com

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