Ask Natural Life:
What is Dental Floss Made Of?
by Wendy Priesnitz
Photo © bikeriderlondon/Shutterstock |
Q: I’ve just come from a dentist appointment, where they cleaned my teeth and sent me home with a goodie bag of toothpaste and floss. I prefer a fluoride-free brand of toothpaste. But now I’m wondering about the ingredients in the floss: It must contain flavorings and who knows what else. Do you know what it's made of? Can I just skip flossing?
A: Dentists have been telling us for decades that the use of dental floss effectively removes plaque, a gel-like substance made of bacteria that forms on and between teeth, as well as below the gum line. It has been thought to be an important part of our dental hygiene routine because normal brushing doesn't remove all the the plaque. And if it is not removed, it hardens and can cause gingivitis or an inflammation of the gums. Eventually, gums begin to separate from the teeth, forming “pockets” that can become infected, ultimately destroying bone and resulting in tooth loss. Flossing disturbs the bacteria, stopping it before it can create plaque. Various studies have shown that, aside from tooth loss, gum disease is a big risk factor for Alzheimer’s and memory issues.
However, doubt has recently been cast on the usefulness of dental flossing to effectively remove plaque. A 2015 investigation by the news organization the Associated Press (AP) involved Freedom of Information requests to the US Department for Health and Human Services (HHS) asking for the research leading to its recommendation in favor of flossing. The HHS subsequently quietly dropped the advice, and Public Health England has also said that it will be reviewing its own guidance on flossing. In a letter to the AP, the US government acknowledged the effectiveness of flossing had never been researched. That seems not to be totally true, because AP looked at twenty-five studies comparing combinations of various toothbrushes and floss and found that the evidence for flossing is "weak, very unreliable," of "very low" quality, and carries "a moderate to large potential for bias."
Even if you decide to continue to continue to floss for now, you are right to question which type of floss to use, for both your health and that of the environment and the rest of civilization.
Some dental floss is made from nylon, a synthetic fiber derived from petroleum products. Petroleum is a non-sustainable resource, the extraction and production of which has had major detrimental impacts on the soil, ground water, surface water, and ecosystems. Nylon takes about fifty years to break down in the environment, and discarded floss (especially when it’s thrown in the toilet) can clog sewers, pollute lakes, and harm wildlife. Floss is also often coated with a petroleum-based wax. Americans buy over three million miles of dental floss every year, so this is substantial damage.
Floss made from polytetrafluoroethylene (PTFE) is becoming increasingly popular – and is marketed to dental offices to be given out to clients. Many people like it because it doesn’t shred and is easier to “glide” between tight teeth and around braces.
Other ingredients can be flavors and additives that vary with the manufacturer and can include fluoride. The summary of one dental floss patent reads: “Porous, high strength (PTFE) dental floss is coated with micro-crystalline wax. If desired, the floss may also incorporate one or more active tartar control, anticaries, antiplaque and/or antibacterial actives and/or dentally acceptable agents such as polishing and abrasive agents, coolants, flavorants and/or coagulants.”
Those can all be problematic for our health, but PTFE is the biggest problem, in my opinion. It also provides the coating in non-stick cookware, under its DuPont trade name Teflon. Although the main concern over Teflon has been the release of toxins when cookware is overheated, a chemical used in its manufacture, called perfluorooctanoic acid (PFOA), creates other problems. PTFE belongs to a class of perfluorochemicals (PFCs), which have become global pollutants in a short period of time. They have been found in our cities, on remote islands, in forests, and in polar regions, showing up in drinking water and wildlife.
Studies also show that nearly all people, regardless of age, have some PFCs in their blood. They have been found in samples of human breast milk, and in the blood of newborns. (Kathleen Arcaro of the University of Massachusetts, who found PFCs in samples of human milk from nursing mothers, says that while nursing does not expose infants to a dose that exceeds recommended limits, breast milk should be considered as an additional source of PFCs when determining a child’s total exposure.)
PFCs are thought to be more persistent in the environment than PCBs and DDT. They have been produced, used, and disposed of essentially without regulation for the last half-century. But even if production were to end today, levels would continue to increase in the environment for many years to come.
The way PFCs get into human blood is not known at this time. We could be exposed through food, water, or the environment where the chemicals have been spilled or released (including in house dust), or by using the hundreds of commercial products containing them – like dental floss and other personal care products, carpets manufactured before 2002, and the grease-resistant packaging in microwave popcorn bags and pizza boxes.
PFCs are thought to be carcinogenic, are suspected endocrine and hormone disruptors, may cause birth defects, are associated with neurological problems such as delayed gross motor development, and suppress the immune response. A recent study published in the journal of Environmental Science & Technology suggests that elevated PFC blood levels may boost ADHD risks by making children prone to impulsive behavior. (The researchers caution that cause and effect are unclear: Children who are more impulsive to begin with may spend more time licking and chewing commercial products, giving them higher exposure to PFCs.)
A study published in January 2012 in the Journal of American Medical Association described how PFCs may interfere with childhood vaccinations. In the study, children who had higher concentrations of PFCs in their blood had lower or virtually no immune responses to diphtheria and tetanus vaccinations. Researchers “were surprised by the steep negative associations, which suggest that PFCs may be more toxic to the immune system than current dioxin exposures.”
Alternatives
Unfortunately, there doesn’t seem to be a definitive, eco-friendly alternative for the basic component of dental floss. But you still have choices. Researchers have compared different types of dental floss and determined that there is no difference in their effectiveness.
The fact that ingredients aren’t often printed on the packaging (especially the little freebies you get from your dentist), makes choosing a safer alternative difficult. Your best bet is a natural food store or co-op. Look for unwaxed or natural vegetable wax coatings, and no flavorings. Many of the alternatives use beeswax, but that might not be suitable if you’re concerned about using animal byproducts.
There are a number of companies selling natural floss made from silk. However, silk is also problematic for vegans and those who focus on animal rights, and can involve child labor and chemical treatments. Nylon filaments woven together and coated with natural wax are a not-so-perfect alternative.
Look for minimal plastic packaging or, even better, recyclable paper fiber packaging. (Regular plastic packaging for floss usually is a Code #5 for plastic recycling – although many do not come with a code number, and not all municipal recycling programs accept Code 5 plastics.)
Floss picks cut down on the actual amount of floss needed, using only one inch instead of eighteen per use, but they are still disposable and the handles are also made from petroleum-based plastic. And please avoid those over-packaged, one-use, throwaway floss picks.
Electric toothbrushes are far superior to brushing with normal brushes in terms of removing plaque. In one study, electric brushes were associated with a twenty-one percent reduction in plaque and an eleven percent reduction in gum inflammation compared with manual brushing. Water piks, which clean your teeth with a high-pressure jet of water are also particularly effective. And regular, twice yearly cleaning by a dental hygienist will get rid of all the remaining plaque.
Wendy Priesnitz is Natural Life’s editor, a journalist with forty years of experience, and the author of thirteen books.
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