Health is a substantial part of everyday life. For most, health plays a critical part inthe life they live today. Not only does it affect a person’s individual wellbeing and quality of life but can impact them through the people around them. With such a vital role in the lives of people it would be reasonably expected that an individual would take all necessary or recommend steps to remain in good health, however this is simply not the case. In a study conducted by Dr. Duong Nguyen found that one third of Americans never floss, a professionally recommend method of maintaining dental health (Manella, Morgan). These findings have led others to question the causation of such a staggering statistic in a first world country. Some people attribute the numbers to factors such as cost, time, or a lack of evidence supporting flossing benefits, however, the disregard for preventative oral health care, the general lack of education on dental health, and poor methods of educating are the main determining factors in why many people don’t floss.   

Oral health is a widely dismissed and undervalued part of overall health in America. Flossing is a key aspect of oral health and reportedly around 1/3 of Americans never floss (Manella, Morgan). These alarming numbers have led to little to no attention on the issue and flossing is continually ignored. Some attribute the lack of flossing to laziness, however this is just a symptom of the larger problem. According to Joni Nelson, author of the dissertation “By Word of Mouth: A Qualitative Approach to Understanding the Integration of Preventive Dental Health in Primary Care Settings”, the “Deterioration of oral health can impede social development, encourage various levels of discomfort, and create a pathway for negative impacts on quality of life” (Nelson, Joni). Not only does improper oral hygiene impact health but also social interactions and quality of life. Despite this, preventative oral health is dismissed and ignored as optional. Nelson comments on this in her statement “competing health education topics limits the priority placed on oral health and its relation to overall general health and wellness” which discuss how other health information is prioritized over oral health and thus overshadows it and makes it appear less important than other aspects of health (Nelson, Joni). This blatant dismissal of preventive oral health can be seen in the article “Telling Them to Brush and Floss Is Just Not Working”, author Rebecca Wilder states that “half of all health recommendations are not adhered to by the patient”(Wilder, Rebecca). The failure to adhere to medical recommendation by 50% of patients shows the true extent to which oral health is ignored. It illustrates the disregard for preventive oral health and its impact on overall health and has led to the lack of flossing in America. The lack of flossing, however is not solely based in the dismissal of preventive of oral health, as education plays a major role in the disparagingly large portion of Americans who don’t floss. 

Due to the indifference towards oral health in America, education on the topic has suffered deeply. Educating people on the significance of oral health has been shown to have a profound effect on the dental health habits of Americans. In the study "Effects of a Short Behavioural Intervention for Dental Flossing: Randomized-Controlled Trial on Planning When, Where and How" conducted by Schüz, Benjamin, et al found that brief informational meetings on proper dental health could dramatically impact a person’s daily dental health habits.  The study followed 194 participants who were either placed in a control group, not receiving any information, or the test group, receiving the brief informational session. After its completion, the study concluded that the participants who received the brief informational intervention were significantly more likely to exceed the dental health performance of those who did not over a period of 8 weeks (Schüz, Benjamin, et al). This information shows the long term effect on the dental health habits of people when educated on the topic. It demonstrates the sheer impact simple educational meetings can have on dental health habits. The information provided to the participants clearly impacted their dental health habits and thus shows a clear connection between an individual’s education of oral health and their flossing habits. Not only did the informational sessions improve the performance of those in the study over those who were in the control group, the effects of the study had lasting results on the participants oral health habits for a period of at least 8 weeks. This illustrates that education is not only a major aspect in the dental health and flossing habits but also that it can be used to increase flossing among the general population. Through this method, educational sessions could be used in business, schools, and dentist office to considerably influence the flossing habits and overall dental health of Americans.

 Despite the seemingly significant impact of education in flossing habits, the method of education is just as imperative to a person’s dental health. The simple routine of dentists scolding patients from improper flossing with promises of gingivitis that never seem to occur, just does not provide the correct motivation for changing the way people approach dental health. In the article "Telling Them to Brush and Floss Is Just Not Working" by Rebecca Wilder stated that within an hour, up to 60% percent of oral health information learned is forgotten. Wilder also claims that out of all the recommendations patient receive only a half of them are actually implemented by the individual (Wilder, Rebecca). This information emphasizes not only the failure of traditional education methods of dental health but also the importance of the issue. With consequence of poor dental health ranging from gingivitis to increases in chance of developing other oral diseases and cancers, the lack of compliance to professional recommendation can have catastrophic impact on a person health. With this information, it is abundantly clear that traditional methods of education do not have enough impact alone to affect an individual’s health.  Therefore, it is necessary to develop new methods of education and take new steps to ensure the importance of flossing in dental health to increase flossing rates among Americans. This combined with consistent and meaningful educational settings can dramatically increase dental health in America, although some would disagree. 

One factor that is offend attributed to the absence of flossing is cost. It can be argued that if an individual cannot afford the cost of multiple dental hygiene products that flossing would likely be deemed less important than say toothpaste. However, when considering that the cost of dental floss is around 3 cents per yard, the question of price does not appear to be an issue. On the other hand, the price of not flossing can be astronomical in comparison.  According to an article “No Dental Insurance? Don’t Wait for Something to Go Wrong” by Elizabeth Renter the cost of a filling a cavity is estimated to be around 170 dollars and the treatment for advanced gingivitis, periodontal disease, to be several times more expensive than a normal checkup(Renter, Elizabeth).  With proper dental health, these are some of the many of treatments and expensive costs that could be avoided. The article also discusses the medical repercussions of improper dental health including gum and heart disease as well as oral cancers. Knowing this, it would be illogical to assume that cost is valid reason for not flossing as the cost for not doing so can be far greater. This information highlights not only the need and cost of leaving out preventive oral health measures such as flossing, but why cost is not one of the major reasons behind the flossing epidemic in America.  Another assumption for the cause for the epidemic is time.

An argument by some is that flossing is just too time consuming or is just not worth the time it takes to properly floss. In peoples mourning rush to work or school, flossing is often cut to make time for other task such as a shower or just more sleep. This further shows how oral health can take a backseat in a person life under the presumption that oral health is not worth the time.  This however can be shown to simply not be the case. According to Rebecca Wilder it takes roughly “about 5 to 6 minutes per day to maintain healthy teeth and gingiva” (Wilder, Rebeca). This 5 to 6 minutes not only include flossing but other preventive health measure such as brushing teeth. With this in mind, properly taking care of one’s oral health would take an average of .38% of a day to complete. Wilder also states that it is only necessary to brush and floss once a day to stop the development of gingivitis, inflammation of the gums and beginning of gum disease. Also in this article Wilder explains that the improper can lead to other health complications involving “systemic health, oral cancer, possible sleep apnea issues, etc.” (Wilder, Rebeca). Furthermore, the time it takes to effectively clean one’s teeth far out ways the negative cost of improper dental hygiene. Because of this, time does not appear to be a substantial reason or valid reason for not flossing.

With the recent removal of flossing from the federal Department of Health and Human Services some have called into question the importance of flossing in dental health. In the article “Feeling Guilty About Not Flossing? Maybe There's No Need” author Catherine Louis uses the lack of studies and evidence supporting flossing as useful or even effective at preventing tooth decay to call into questions its value in dental health (Louis, Catherine). This seemingly lack of evidence however comes with a valid explanation. According to the video “Have You Tossed The Dental Floss? Your Dentist Isn't Happy” by ACSHonTV the lack of supporting studies showing the effectiveness of flossing is because of ethical issues. They claim that it would be unethical to instruct participants to not floss, a professionally recommend method of maintaining dental health, for an extended period of time (ACSHonTV. YouTube). This claim explains the lack of evidence of supporting flossing however it does not explain if it is beneficial for preventing tooth decay or not. This is addressed in Louis own article that states “there is some mediocre evidence that flossing does reduce bloody gums and inflammation known as gingivitis” as well as “ A review of six trials found that when professionals flossed the teeth of children on school days for almost two years, they saw a 40 percent reduction in the risk of cavities”(Louis, Catherine). These statements alone show there is some merit to flossing and that although there may be a current lack of evidence supporting the extent of its benefits, there is nothing to lose from the daily cleaning.

With this information on the main cause of the flossing and oral health problem in America, the question then becomes what can we do about it? The best way to fix this issue is to fix the problem at its source, education. Not only is general education on oral health and hygiene as well its repercussions for neglecting it, but also how people are educated. To ensure the problem is fully address and not temporarily fixed all aspects of education must be addressed. In order to do this, it is necessary to develop new methods of educating people on the subject as well as inserting them in key places in society. One solution to this issue would be the implementation of interactive and intensive educational sessions in business and schools. The education of children will help install habits of good oral health practices early that will hopefully remain for life. The addressing of adults will help fix the current flossing epidemic and through extension their children. Nelson, author of “By Word of Mouth: A Qualitative Approach to Understanding the Integration of Preventive Dental Health in Primary Care Settings”, comments on this when she says “Oral health promotion should be a priority for public health researchers, dental health professionals, medical providers, families, community liaisons, policymakers and adolescents. By working together, these members of the collective leadership can make strides towards reducing the debilitating effects of poor oral health”(Nelson 24). This statement supports the joint action of a community and society to ensure the addressing of the issue. However, this alone is not enough. As mention in Rebeca Wilder’s “Telling Them to Brush and Floss Is Just Not Working” education alone will not fix the issue. Instead the method educating must also be changed as stated in the sentence “motivation to change is elicited from the patient/client, and that it is the patient/client's responsibility, not the dental hygienist's, to voice and resolve his/her ambivalence to the behavior”(Wilder, Rebecca). This implies that the patient’s behavior must be addressed for the importance and value of oral hygiene to truly become important to them. Both of these sources have different ideas on how to fix the issue we face today, and both have valid evidence and reasoning supporting their ideas. Therefore, it is necessary to introduce both methods in the education of Americans on proper dental health habits to completely addresses the flossing issue in America.

Flossing is a vital part of daily and routine maintenance of an individual’s oral health. Despite this it is widely ignored, with up to 1/3 of Americans never flossing. As a result, the oral health of America is suffering. To combat this issue, it is necessary to take action and address the root of the issues, education and the importance of oral health. Oral health in America is dismissed as less important as other forms of health are prioritized. In order to correct this issue, oral health must be recognized as an important aspect of health by the general public. The poor education methods and information of dental health in America is one of the major reason flossing is widely ignored. Not only must education be addressed but the methods of education. In order to fully resolve the issue, it is necessary to combine education with the addressing of an individual’s behavior and habits towards oral health to inform the general public and ensure oral health is taken seriously in America. Already consequence of the continuous neglect of oral health an America can be seen in the poor dental health of adolescence of the future generations. According to Joni D Nelson in the dissertation “Word of Mouth: A Qualitative Approach to Understanding the Integration of Preventive Dental Health in Primary Care Settings” half of children from ages 12 to 15 have already experienced tooth decay as a result of improper dental health. If this problem is left unaddressed not only will oral health in America continued to decline, it could lead to a devastating impact on the health of future generations. This critical stage has not been reached yet and can still be easily prevented if adequate steps are taken to address the issue. Therefore, it is crucial to take affirmative action correcting the flawed oral health education and its methods in America before it is too late.
