When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.
A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.
If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.
Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.
A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.
A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.