
Your dentist might be nagging you to floss to avoid cavities, but does flossing have more to given than pearly whites? Interdental cleaning has been recommended for a while, but for many people it’s a habit hard to maintain. Norman and Tegan pick through the history of flossing, and whether it can improve your heart and brain health too. Terms and conditions of our World Science Festival Brisbane ticket giveaway! References: Ask the Expert: Do I Really Need to Floss? - NIH Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries Flossing Is Associated with Improved Oral Health in Older Adults Does flossing before or after brushing influence the reduction in the plaque index? A systematic review and meta-analysis Why would cardiovascular disease and poor oral health be connected? - Harvard Health Oral health and later coronary heart disease: Cohort study of one million people Stronger connec...
Loading summary
A
ABC Listen.
B
Podcasts, radio, news, music and more.
A
Anthony Burke here, host of By Design on ABC Radio National, a show about the clever ideas and human stories behind the spaces, systems and objects shaping everyday life. Whether you're curious about architecture, interior design, fashion, or anything in between, we reveal why design matters in a rapidly changing world. By Design on abc. Listen. So guess what I was doing just before I came into the studio?
B
I know what you were doing right before you came into the studio because.
A
You were in Brisbane and I was.
B
No, no, I know you. I know your habits, some of them. And I know that before you talk into a microphone, you have a compulsion to brush your teeth.
A
It is a compulsion, yes. It's a healthy compulsion, but a compulsion nonetheless. Yep.
B
I don't. If this microphone could talk, it would tell you what I had for lunch.
A
Do you just smile into the camera for us and we can just see what's between your teeth?
B
I think you're seeing pearl barley and cabbage.
A
Oh, very good.
B
Cause I'm eating like a European peasant at the moment.
A
Excellent.
B
Lentils. Okay, so you brush your teeth almost every time you speak into a microphone. Do you go the extra mile and also floss?
A
I did today, as a matter of fact, because I had a multigrain sandwich and there was just too much going on in that sandwich.
B
I wasn't worried I was gonna be able to hear the spinach in your teeth.
A
That's right. So I did floss as well. I didn't interdent, but I did floss.
B
So flossing a SM for oral health, could it actually make you smarter? That's kind of the question on WhatsApp.
A
Rush today, which is the podcast where we answer the health questions that simply everyone is asking.
B
So this week's question comes from Carrie. It's quite a specific question. So Carrie writes, longtime listener of the show, first time emailer. Hi, Carrie. Carrie says my dentist has nagged me for years to floss my teeth, and I finally started a year ago and have found significant improvement in my oral health ever since. Who knew? Since then, I've read various headlines that flossing your teeth can help protect you from various ailments such as heart disease, stroke, and Alzheimer's disease. Are these claims true? If that's the case, should we all be trying to use the infrared light toothbrush cleaning devices my social media feed keeps trying to sell me in an effort to further reduce orally introduced bacteria into our bodies? And she finishes. Keep up the good work.
A
Good question.
B
Lots of good questions. Okay, so what I'm hearing in Carrie's question is it's not so much about oral health. We can talk about it, but that's not really the core of the question. It's, has flossing got any relationship to heart disease, stroke and Alzheimer's? And what do we know about infrared toothbrushes? So I suppose as good a place as any is to talk about flossing as a concept. So you are a flosser, Norman, I.
A
Am a flosser and I am also an interdenter.
B
What's the difference?
A
Well, you see, I've got a crowded mouth, and I probably should have had that separated out when I was a child, but my parents couldn't afford it, so I've got a crowded mouth. So interdenting gets rid of stuff that is in between your teeth, and flossing will get rid of anything that's caught in the tight spaces between my teeth, which the interdent doesn't get to.
B
So you interdent. It's one of those little things that looks like a pipe cleaner, like on a little.
A
That's the one I use. Yeah.
B
Cleaning with a little tiny toothbrush between your teeth.
A
Here's the other thing. I brush my teeth first with the fluoride toothpaste, and I try and keep as much of the toothpaste in my mouth for as long as possible because the dentist once told me that we don't get the maximum effect of the fluoride by getting rid of the toothpaste as quickly as possible. So I do all that imagining that this is going to be really good for my teeth. Interdenting and flossing and keeping the fluoridated toothpaste in contact with my teeth as much as possible.
B
How long is this taking you?
A
It doesn't take me that long. A couple of minutes, Maybe three, maybe four. Not ten.
B
Okay, that's good. So, yeah, flossing. It's cleaning the teeth. We know that you don't want to.
A
Be near anybody else when you do it. Can I just say that?
B
You know what I mean, you're just flicking. Well, we know that. Maybe you don't know. You know this, Norman. I think it's worth a reminder of, like, what's happening inside our mouths most of the time, and it's that our mouths are innately disgusting, full of bacteria, the sticky kind of biofilm. You know, when your teeth feel a little bit furry? You don't, because you're brushing your teeth constantly. But the rest of us kind of probably familiar with that, that feeling of your teeth feeling A little bit, perhaps furry after a meal. That's food particles plus bacteria combining, joining together, digesting the food particles left on your food, which then can cause plaque, which can then turn into, well, all sorts of things. Yeah, Calculus that you can't sort of get off with. Brushing and flossing can lead to decay, it can lead to gum disease, it can just lead into an already disgusting mouth becoming even yuckier.
A
Yes.
B
And I'm sorry, I'm sounding very flippant here. I think that oral health is actually one of those things that we don't prioritise enough in Australia and that it is very much a question of access and equity. But at the biological level, that is actually what's going on.
A
Yeah. I mean, the health system behaves as though the mouth isn't part of the body. Seriously, I mean, you. We don't have a reimbursement system, apart from private health insurance for dentists. Dentists aren't fully. It's not their fault. They're not fully integrated into the healthcare system. They are in hospitals. Most hospitals have some public dental chairs, but we seriously underplay public dentistry. And a lot of dentists would love to be more involved in the healthcare system, but they aren't. A lot of diseases are diagnosed in the mouth and dentists have been much more focused on prevention than many doctors. I mean, they were the ones who pioneered fluoride and that did them out of some business because they were preserving teeth. So there's a lot to be said for what dentists have done in terms of preventive health. And they believe strongly that flossing and, you know, inter dental work is really important for your oral health and some would say your physical health, which is really what this question's all about.
B
But before we get to that, I do want to have a little trip down memory lane because, you know that that's my favourite thing. Would you like to hazard a guess as to the year that dental floss became a thing?
A
It's an interesting question. I mean, I think historically people putting wood and toothpicks into their mouths would probably go back centuries. But actually flossing, I would have thought that's pretty, let's say post World War II.
B
No, earlier than that, but not that much. I think with some of these topics, I'm always surprised at how recent it is. Given that humans have had teeth since we became humans, we come to this oral health thing quite late and it has to do with the way our diets have changed over that time. And when it comes to Floss we have to thank for it. A gentleman called Levi Spear Palmley. He was from New Orleans in the states, and in 1819, he recommended running a waxed silk thread through the interstices of the teeth between their necks and the arches of the gum to dislodge that irritating matter which no brush can remove and which is the real source of disease. And then he goes on to say, with this apparatus thus regularly and daily used, the teeth and gums will be preserved free from disease. I do love the way they spoke in 1819 and thereabouts. But the actual floss, like he sort of recommended wax, silk thread, probably not that hard to make yourself, but you could buy commercially available floss from that 1882 onwards. There's also an incredible. Every now and again, Norman, I'm sad that we are a podcast and people can't see the visuals that I get to look at in the research for this. There's a really fantastic pamphlet from 1819 by one Mr. Palmley, or Dr. Palmley, I suppose it's called. I'm going to try to approximate with my volume of my voice, the different font sizes used in this title. A practical guide to the management of the teeth, comprising the discovery of the origin of caries or decay of the teeth with its prevention and cure.
A
Sounds like Donald Trump on Truth Social.
B
It is in all caps. So, yes, Anyway, so that's the origin of flossing. We thank Dr. Palmley, Professor Palmley, whatever honorific you prefer, sir. And I guess then the question is, now that we've established that, yes, good for oral health, we come to the question of whether it's got any relevance to the rest of the body.
A
Yeah. And this revolves around the gums. So inflammation of the gums, which is gingivitis, and a more extensive inflammatory condition called periodontitis, where the gums pull away from the teeth. And the thought has been. And the people have produced evidence to suggest that when you've got inflammation in the gums, it's usually a bacterial cause. There is an association between gum inflammation of various kinds and coronary heart disease. And some people believe there's an association with dementia as well. And the theory is, well, twofold. One is you set up inflammation in the gums that activates your immune system. An activated immune system makes you more likely to deposit cholesterol in your arteries because it needs inflammation to do that and create atherosclerosis and therefore heart attacks. The other theory, which is not exclusive to that, that the bacteria, or parts of the bacteria escape from the gums into your bloodstream and lodge in the arteries. And in the arteries create inflammation, which then pulls the cholesterol in, oxidizes it, and creates atherosclerosis. There's a different theory for Alzheimer's disease, that one of the bacteria, Porphyromonas gingivalis, and it is involved in the destruction of gum tissue. And they believe that what it does, if fragments of this bug get into the brain, can induce the two damaging processes that are part of Alzheimer's disease. They're not necessarily the cause, but they're part of Alzheimer's disease. One is a protein called tau, which gets inside nerve cells and causes things called tangles. And it looks as though porphyromonas gingivals can induce the production of tau. And also another PA has looked at the beta amyloid that goes around the nerve cells and is associated with Alzheimer's disease. That this bug seems to be able to be associated with that. And so the process they actually think is happening is that the bug produces an enzyme, and this enzyme induces these two proteins to be positive, either inside the cell or around the cell, and therefore associated with Alzheimer's disease. And again, in an epidemiological sense, there is an association between gum disease and these conditions.
B
But correlation does not equal causation. And there might be other things at play.
A
That's right. So people who have gum disease tend to be poorer than people who don't have gum disease. They've got less time in their lives, they're more pressed. They don't tend to their health quite as well because they've got other things going on in their lives. And they may not have the same level of dental hygiene. They may not floss simply because of their socioeconomic circumstances and that the diet that they're on, they tend to be more likely to be smokers, and smoking is associated with these conditions. So there's evidence that there's a strong association between gum inflammation, coronary heart disease, less strong, with Alzheimer's disease, and dementia, but it's there. And the question is, is that a side effect of people's lifestyle rather than the gum disease itself? And it hasn't really been sorted out.
B
Well, there was one study that tried to tease apart these different things, especially when it came to coronary heart disease, not Alzheimer's, but coronary heart disease and oral health. And they basically looked at people, it looked like there was this link between poor oral health and heart disease. But once they adjusted for age and other factors, like the sort of things you were saying, that association kind of disappeared.
A
Yeah. And it's very hard to do a clinical trial because there's no placebo control here.
B
You can't blind yourself to flossing. You know you're doing it, you know you're doing it.
A
I'm getting a bit premature to go to the bottom line, but it's worth emphasizing. The bottom line here is flossing and going interdental with an interdental brush are good for oral hygiene. They're good for preventing plaque and calculus and therefore dental decay. So if you make no more than that, it's good for your oral health. If that's all that it does, that's pretty good. Because there have been studies just looking at oral health, particularly in older people, is that people who floss have more of their native teeth than people who don't floss. You could say, well, that's part of diet early in life and what have you. But there is a relationship between flossing and what they call dmf. Decayed, missing and filled teeth.
B
DMF sounds like something you'd put in a dating profile.
A
Well, it probably is. You know, you smell and you have these twinkling ivories and I only have three dmf, you know, go for me, baby. Unfortunately, I grew up in Glasgow and I've got a DMF score that's off the scale.
B
Norman's DMF through the roof. So I kind of feel like we're making pretty short work of this question from Carrie, who I just realized has a name quite similar to dental caries. Is there anything to this idea of heart disease, stroke or Alzheimer's being linked to your gum health?
A
Well, as we just said, there is. If you value your mouth, there's a chance you are actually improving the rest of your health. And what are you losing out of that? It's not as if you're taking a toxic drug. You are improving your oral health. You're going to make dentists work easier and preserve your teeth for longer. And if it has an effect on your brain and your heart, that's an extra bonus.
B
Ok, so flossing equals good. I think we can say that that's the case. Oral health should enough for you, but there could be some potential bonus points in terms of your heart and brain health. Probably not. But why not? Just in case. The other question she asked was about infrared light toothbrushes. And I think the idea here is that they are killing the bacteria that's in your mouth.
A
And I think they're combating inflammation as well.
B
Right. What do we think about these, Norman?
A
Look, the jury's out on the actual toothbrushes dentists do have. I don't know whether all have that, but dentists do use either laser technology or infrared technology to help treat. Treat periodontitis to some effect. But that's a known dose and it's given in controlled circumstances in a targeted way. We really don't know the effect of the infrared toothbrushes. There are poorly conducted studies which suggest benefit. Why wouldn't they? Because they're probably sponsored by the manufacturer and you just don't know what good they're doing and whether you're getting value for money.
B
Would they be dangerous? Is it? I mean, if something's going to potentially have an effect, it could potentially have a negative effect.
A
Well, in general principles, you wouldn't want to be heating up tissue unnecessarily. That's not necessarily good for your tissue. Probably no harm, but it'll harm your pocket. We just don't know. I mean, here's the bottom line, which we've said often on what's that Rash. If an intervention is strong enough to do you good, it's strong enough to do you harm. There really is no such thing as a harmless intervention that does you good. So on that principle, you'd have to say there's the potential for harm, even if there's the potential for good. And as far as I'm concerned, I'm quite happy to stick with my flossing and intradent.
B
Okay, then. So if anything that can have benefit could also have harm. Is there a potential harm to flossing too much?
A
Well, there's probably a bit of harm of washing your teeth too much, and I'm aware of that. So my understanding of the evidence is that when you have a meal, it softens the enamel on your teeth, and therefore you don't want to brush your teeth immediately after a meal. You want to wait a while so that the teeth have recovered from the meal itself. So it goes back to the original dental advice that you should wash your teeth two or three times a day, but not too soon after a meal is what people say. So I try to avoid flossing my teeth too soon after eating, but on a day like today, I broke that rule.
B
Okay, so Carrie's already brushing, she's already flossing, she's on paper doing everything. Right. Does it make a difference what order you do these things in?
A
Well, that's a matter of big debate. Do you brush your teeth Then floss or floss and then brush your teeth.
B
I always floss my teeth first. I don't know why. I kind of imagine it kind of frees up my toothbrush to go where no toothbrush has ever gone before.
A
Well, you see, now do it for the other reason, which is I want that fluoridated toothpaste to go to as many different parts of my mouth as possible. And I can imagine when I'm sort of zzzed away with the intradent, that's rubbing in the fluoridation. Turns out I'm fantasizing about that. It doesn't make much difference either way whether you do first or second, as long as you do it.
B
And the bottom line for the infrared.
A
Toothbrush, save you money, I think.
B
What about. Oh, we didn't talk about them. Norman. We might need to save this for another episode. Water. The water flosser.
A
Yeah, let's save that for another time.
B
Alright then. Got to keep the people wanting more. Well, thank you so much, Carrie, for your question. If you want to ask your question, our email address is thatrashbc.netau before we.
A
Get to the meal bag, we have tickets to give away to the World Science Festival Brisbane. Two double passes, terms and conditions are linked on our website and all you need to do is sign up for the ABC Health newsletter or show us you've already signed. Signed up for a chance to win. It's on Saturday, March 28 in Brisbane at the World Science Festival in South Bank, Brisbane. If you're not in Brisbane that weekend, catch a plane. We can't afford to pay for your air tickets, but we can give you two free tickets if you win our competition. Saturday, March 28th in Brisbane at the World Science Festival.
B
Yes, we are coming live to the World Science Festival and yeah, sign up for the ABC Health newsletter, which is a bonus because the ABC Health newsletter.
A
Is really great and it's gonna be huge. Huge, huge, huge. So what's in the mailbag?
B
Mailbag? Well, in the mailbag is a reply from last week's question asker, Thomas, who was young. Yes, Thomas was a young man asking whether there were any scientifically backed reasons to do nothing. We said, yes, Thomas, there is. And maybe doing some mindless chores like folding the washing could be a way to access that mental state. Thomas writes, thank you very much for answering my question. You've certainly given me scientifically backed reasoning to do nothing. The only problem now, after showing my mum the episode, she also has scientific backing to make me do more washing.
A
Yes, you're welcome. Thomas's mum and sue writes.
B
Sue says she first got into actively doing nothing in the year 2000 when I began living on a rural property alone with my cat and chooks in southern New South Wales. Car radio reception was poor and I chose not to play music on those frequent three hour drives down to Melbourne. I've heard others refer to shower thoughts and known exactly what they meant. I sometimes have my brightest ideas in the shower too. One of my theories is that this is about the only time in this modern digital world when most people are forced to put their phones down and let their minds free range.
A
Yep. Well that fits with the signs.
B
Sue Are you a shower thoughts guy, Norman, or do you do nothing in different settings?
A
I find there's that sort of of semi somnolent period just when you're lying in bed at night and you're bored with the book that you're reading. The hypnagogic state. I get stuff there and sometimes when I'm at the gym and you know this is kind of not doing nothing, but you're on the static bike and you're in a routine and you're not thinking about it. That's when my mind wanders.
B
I was going to say if you're finding your book boring, you're reading the wrong books. Then I was going to make a gag about you reading your own books, but maybe I'll just leave it there.
A
If I don't read them, who is?
B
Norman's books. You should read them. That's a shameless plug. If you have a question or some feedback for us or anything you'd like to say to us, just email us. We are that rashbc.net au.
ABC News | February 17, 2026
Episode Focus:
This episode investigates whether flossing your teeth can benefit more than just oral health and reduce your risk for heart disease, stroke, or Alzheimer's disease. Hosts Norman Swan and Tegan Taylor address listener Carrie’s question about the broader health impacts of flossing, and offer evidence-based insights on new dental gadgets like infrared toothbrushes.
The discussion centers on the commonly-circulated claims that oral health habits like flossing may prevent serious health issues beyond the mouth, like heart disease and Alzheimer's. The hosts assess scientific evidence behind these headlines and clarify what flossing is actually proven to do.
This episode maintains a conversational, lightly humorous tone, but stays focused on science and practical advice. If you keep your teeth clean, you’re already ahead—even if your heart and brain don’t directly reap extra benefits. As Norman sums it up:
"If it has an effect on your brain and your heart, that's an extra bonus." (13:35)
For detailed answers to water flossers or to submit your own health queries, stay tuned or contact the show!