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Flossing as it’s known today started in the United States as early as 1815, when an American dentist, Dr. Levi Spear Parmly, introduced the idea of using waxed silken thread as floss. Later, he published a book, A Practical Guide to the Management of Teeth that emphasized the importance of brushing and flossing daily. The type of material used for floss evolved over time. It started with unwaxed silk floss and then nylon during World War II. Today, there are varieties made of Gore-Tex and spongy and soft floss for sensitive gums as well as water flossers.

Although the types of floss and its material evolved over time to make it more comfortable and accessible to the public, it still hasn’t quite caught on fully. The American Dental Association has noted that only four out of every 10 Americans floss at least once a day, and 20 percent never floss. The Oral Health Foundation in the United Kingdom noted that less than 25 percent of adults use dental floss regularly, and one in three never floss their teeth.

In 2016, the Associated Press set out to find how effective flossing really is since it’s been formally recommended for so long. They asked the departments of Health and Human Services and Agriculture for their evidence on flossing and followed up with written requests under the Freedom of Information Act. After looking at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss, the AP found the evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.”