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Outdated methods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studies used outdated meth-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.
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