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12A THE DAILY ASTORIAN • TUESDAY, AUGUST 2, 2016 Floss: ADA has been promoting loss universally since 1908 Continued from Page 1A Investigation Last year, the Associated Press asked the departments of Health and Human Services and Agriculture for their evi- dence, and followed up with written requests under the Free- dom of Information Act. When the federal govern- ment issued its latest dietary guidelines this year, the loss- ing recommendation had been removed, without notice. In a letter to the AP, the government acknowledged the effective- ness of lossing had never been researched, as required. The AP looked at the most rigorous research conducted over the past decade, focus- ing on 25 studies that gen- erally compared the use of a toothbrush with the combina- tion of toothbrushes and loss. The indings? The evidence for lossing is “weak, very unre- liable,” of “very low” quality, and carries “a moderate to large potential for bias.” “The majority of avail- able studies fail to demon- strate that lossing is generally effective in plaque removal,” said one review conducted last year. Another 2015 review cites “inconsistent/weak evi- dence” for lossing and a “lack of eficacy.” One study in 2011 did credit loss with a slight reduction in gum inlammation — which can sometimes develop over time into full-ledged gum dis- ease. However, the reviewers ranked the evidence as “very unreliable.” A commentary in a dental magazine stated that any beneit would be so minute it might not be noticed by users. Outdated methods The two leading profes- sional groups — the Ameri- can Dental Association and the American Academy of Peri- odontology, for specialists in gum disease and implants — cited other studies as proof of their claims that lossing pre- vents buildup of gunk known as plaque, early gum inlamma- tion called gingivitis, and tooth decay. However, most of these studies used outdated meth- ods or tested few people. Some lasted only two weeks, far too brief for a cavity or dental dis- ease to develop. One tested 25 people after only a single use of loss. Such research, like the reviewed studies, focused on warning signs like bleeding and inlammation, barely dealing with gum disease or cavities. Wayne Aldredge, president of the periodontists’ group, acknowledged the weak sci- entiic evidence and the brief duration of many studies. In an interview at his private prac- tice in New Jersey, he said that the impact of loss might be clearer if researchers focused on patients at the highest risk of gum disease, such as diabetics and smokers. Still, he urges his patients to loss to help avoid gum dis- ease. “It’s like building a house and not painting two sides of it,” he said. “Ultimately those two sides are going to rot away quicker.” Aldredge also said many people use loss incorrectly, moving it in a sawing motion instead of up and down the sides of the teeth. Pressed about the origins of his organization’s Courtesy of Clatsop County Historical Society The Tourist No. 2 ferried tourists and their cars from Astoria to Megler until the Astoria Bridge opened 50 years ago. AP Photo/Julio Cortez Dr. Wayne Aldredge, president of the American Academy of Periodontology, holds a piece of dental floss at his of- fice in Holmdel, N.J. Aldredge acknowledges the weak sci- entific evidence and the brief duration of many studies on flossing, but says that the impact of floss might be clearer if researchers focused on patients at the highest risk of gum disease, such as diabetics and smokers. ‘We know there’s a possibility that it works, so we feel comfortable telling people to go ahead and do it.’ Tim Iafolla National Institutes of Health dentist endorsement of lossing, he said it may simply have “taken the ADA’s lead.” When the ADA was asked for proof of its claim that loss- ing helps prevent early gum disease and cavities, the group cited the 2011 review and a 2008 two-week study that mea- sured bacteria and did not even consider gum disease. In a later statement to the AP, the ADA said loss- ing “removes plaque” and “is proven to help remove” debris from between teeth. A video on its website proclaims that lossing “helps prevent gum disease.” When pressed, Mat- thew J. Messina, a practicing dentist and spokesman for the dental association, acknowl- edged weak evidence, but he blamed research participants who didn’t loss correctly. In the business Even companies with a big market share of the loss- ing business — by next year, the global market is predicted to reach almost $2 billion, with half in the United States, according to publisher Market- SizeInfo.com — struggled to provide convincing evidence of their claims that loss reduces plaque or gingivitis. Yet the industry has paid for most stud- ies and sometimes designed and conducted the research. Procter & Gamble, which claims that its loss ights plaque and gingivitis, pointed to a two-week study, which was discounted as irrelevant in the 2011 research review. Johnson & Johnson spokes- man Marc Boston said loss helps remove plaque. When the AP sent him a list of con- tradicting studies, he declined comment. The loss-making com- panies partner with the ADA through its Seal of Accep- tance program. The ADA pro- motes the seal to companies as something that “directly affects the purchase decisions of con- sumers;” each manufacturer is charged $14,500 for the evalua- tion. If it approves the product, the ADA then charges an addi- tional annual fee of $3,500. The ADA says it rigor- ously evaluates products and makes no proit from the pro- gram. However, loss compa- nies themselves are allowed to design the studies. “The funding can come from companies — no prob- lem at all,” said dentist Marcelo W.B. Araujo, vice president of the ADA’s Science Insti- tute, who joined the organiza- tion after serving as an exec- utive for Johnson & Johnson. “The design can start from the company.” In the beginning When lossing irst gained acceptance, no proof was required of remedies. Dentist Levi Spear Parmly is credited with inventing loss in the early 19th century. By the time the irst loss patent was issued, in 1874, the applicant noted that dentists were widely recom- mending its use. The ADA has been pro- moting loss universally since 1908. “They just looked into what they did every day in their clinical practice and what they would recommend for patients,” said Araujo. Count dentist Damien Walmsley, scientiic adviser to the British Dental Associa- tion, among the skeptics. “It’s important to tell people to do the basics. Flossing is not part of the basics.” Floss can occasionally cause harm. Careless loss- ing can damage gums, teeth and dental work. Though fre- quency is unclear, loss can dislodge bad bacteria that invade the bloodstream and cause dangerous infections, especially in people with weak immunity, according to the medical literature. National Institutes of Health dentist Tim Iafolla acknowledged that if the high- est standards of science were applied in keeping with the lossing reviews of the past decade, “then it would be appropriate to drop the loss guidelines.” Regardless, he added, Americans should still loss. “It’s low risk, low cost,” he said. “We know there’s a possi- bility that it works, so we feel comfortable telling people to go ahead and do it.” PERS: Board will send employers their new rates in September. Rates will take effect July 1 Continued from Page 1A PERS resets public employers’ required payments every two years to pay down any deicit and return the fund to a fully funded status over a 20-year period. At the meeting Friday, an actuary said that even if PERS investments reached their assumed returns of 7.5 percent, contribution rates will have to go up by about 4 percent of payroll in 2017, 2019 and 2021, putting contributions to the system at about $4.5 billion in 2021 compared with $2 bil- lion in the current biennium. John Thomas, a Eugene beneits consultant who chairs the PERS Board, said a spike in returns isn’t going to solve the problem in the long term. “It’s a systemic problem,” he said. “Everything is pred- icated on a linear 7.5 percent investment return, and that has not been sustainable. It’s a whole different paradigm to what we’ve been used to in the past.” The shortfall leaves school districts facing a $335 million increase in costs next bien- nium, which some Republi- can lawmakers have equated to hiring 2,000 new teachers. “Unsustainable and esca- lating PERS costs will not lead to reducing class sizes, add- ing school days, or making our communities safer,” Senate Republican Leader Ted Ferri- oli of John Day said in a news release sent out Friday. “We need fair and constitutional PERS solutions that reduce costs, ensure the long-term sta- bility of the system to protect retirees, and allow for invest- ments in education.” State agencies will see their PERS bill increase by $260 million, and other public employers will have $290 mil- lion in new expenses. Republican lawmakers have compiled a list of mon- ey-saving pension reforms, but Gov. Kate Brown and Demo- cratic lawmakers did not take up any of the proposals in the 2015 legislative session or this year’s short session. The PERS Board will send employers their new rates in September. The rates will take effect July 1. Ferry: ‘It’s great to see the ferry make the trip home’ Continued from Page 1A Washington, before the Asto- ria Bridge was built in 1966. The nonproit Astoria Ferry, which has placed a $15,000 deposit to buy the ferry from owner Christian Lint, timed the homecoming to take advantage of the nostalgia around the 50th anniversary of the bridge this month. “So we think it’s a pretty good, brilliant idea,” Taylor told the Astoria City Council Monday night. Others think the ferry might be better off on land than the Columbia River. Ron Stidham, of Olney, worked on the Astoria fer- ries from 1956 to 1966. He recalled that the Tourist No. 2, which has been signii- cantly modiied, “always han- dled the best.” Though he is happy to reunite with a piece of Asto- ria maritime history, Stidham is skeptical that the ferry will be used to take passengers on chartered trips or be rented out for private parties. He suspects that the Coast Guard safety regulations that must be met, and the cost of maintenance involved in keeping the boat on the water, will make the current busi- ness plan problematic. “I hope I’m wrong on that, but it doesn’t seem to me that Submitted Photo This photo of the ferry sign at Megler was taken in May 1931. it would work,” he said. When he irst heard that the Tourist No. 2 might return, he thought that the ferry should be presented as a static attraction in Heri- tage Square, a way to turn the unlovely pit into a locus of community pride. “I think that’s where it would do the most good,” Stidham said. He envisions an area with benches, picnic tables, rose gardens and, at the center, the ferry, which could still be used for parties, weddings and other occasions. “It would be a draw, and the core area’s crying for something,” he said. At Heritage Square, the Tourist No. 2 could be pre- served as a reminder of the city’s history, much like the Peacock, the pilot boat out- side the Columbia River Mar- itime Museum. Dave Pearson, the dep- uty director at the Maritime Museum, is taking a wait- and-see approach. “It’s great to see the ferry make the trip home,” he said. “Our under- standing is this is short term. We will wait to see what they have in mind for a business model.” Erick Bengel contributed to this report. S A Y G O O D B Y E to Steve Forrester WEL C O M E David Pero Come to The Daily Astorian 5 – 7 pm • Wednesday • August 3 Light refreshments T HE D AIL Y A STORIAN