Flossing, a daily oral-care practice of passing a thin strand between teeth to clear the bacterial film a toothbrush misses, is inexpensive and low-risk. Short trials suggest a small reduction in gum inflammation, though small brushes made to fit between teeth appear to work at least as well. Long-running population studies link regular flossing with fewer strokes and longer survival, but these links may partly reflect lifestyle rather than floss. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Bleeding on probing (% of sites) | Below 10% of sites | Falls as gum inflammation resolves |
| Probing pocket depth | 3 mm or less at all sites | Shallower pockets as inflammation resolves |
| Interproximal clinical attachment level | No established target; track change from own baseline | Slower attachment loss |
| New decay between teeth (bitewing X-rays) | No established target; track new lesions versus baseline | Fewer new decay lesions between teeth |
| Platelet count (only during chemotherapy or with bleeding disorders) | 150–450 × 10⁹/L | Safety check: low counts may pause flossing under oncology direction |
| INR clotting test (only on anticoagulants such as warfarin) | Per usual clotting tests; a high INR changes how flossing is done | Safety check: an elevated INR increases gum bleeding during flossing |
Cadence: Baseline dental examination before starting; dental check at 3 months after starting daily flossing, then every 6–12 months (3–4 months with periodontitis)