If you’ve been hearing about PFAS, or perfluoroalkyl substances, everywhere lately, that’s probably because research seems to be finding them in all sorts of places. PFAS are chemicals commonly used in both industrial and consumer products that break down very slowly over time—hence the nickname “forever chemicals.”
One product that’s been getting attention for PFAS more recently is dental floss.
Researchers found that women who flossed with Oral-B Glide dental floss or floss from other brands had higher levels of PFAS in their blood than women who did not use those types of floss.
Are the PFAS levels in dental floss enough to be a health concern, and are there “clean” floss alternatives? Here’s what dental experts say.
Are There Toxic Ingredients in Dental Floss?
Floss is typically made up of ingredients like Teflon, petroleum-based nylon, or vegetable-based nylon and silk, Jennifer Blanton, DDS, Staff Dentist at UTHealth Houston School of Dentistry, told Verywell in an email. They can also be coated in wax, glycerin, or PFAS chemicals to improve the overall “glide,” said Blanton.
One of the more concerning ingredients is Teflon. Teflon is produced from PFAS chemicals—the same chemical group as the coating on many brands of non-stick pans, waterproof clothing and furniture, and personal care products, like shampoo and nail polish.
“Teflon is produced from PFAS chemicals and may be a concern due to links to kidney disease, liver disease, cancers, infertility, etc,” said Blanton. Teflon exposure has also been linked to autoimmune disease, neurotoxicity, and Alzheimer’s disease.
Other ingredients in floss that may be of concern are petroleum-based polymers like nylon and polyester, the latter of which “has been identified as a carcinogen and hormone disruptor,” said Blanton. However, more research is needed to better understand the potential health effects of petroleum in dental floss.
According to Blanton, silk-based floss would be considered the least likely to cause any harm because it is made from natural, biodegradable materials that are free from PFAS and other plastic particles.
How Worried Should You Be About Dental Floss and PFAS?
The reality is that PFAS are all around us. They’re in water and soil and can be detected in the bodies of almost all humans, according to Blanton. As mentioned before, they’re also commonly used to make consumer products, including fabrics, carpets, cleaning products, and even floss.
“We are exposed to PFAS chemicals throughout our day, from water, soil, fish/shellfish, carpet, cleaning products, and more,” Blanton said, adding that due to the numerous sources of PFAS in our environment, it is difficult to identify which sources are the most significant contributors to overall PFAS exposure.
Sangeetha Chandrasekaran, BDS, MS, a professor and the chair of the Division of Periodontics at the University of Colorado School of Dental Medicine, told Verywell that more studies are needed to understand whether flossing alone contributes to higher levels of PFAS exposure or carries any significant health risks.
“The results from the 2019 study do not confirm that flossing alone contributed to the higher levels of PFAS found in those subjects,” said Chandrasekaran. “With the lack of evidence, all flosses are considered safe. However, for those consumers who may be concerned, multiple alternative flosses are available.”
Awareness of PFAS in your daily life is fine, but Blanton said you don’t need to panic. If you want to be extra cautious and limit your exposure to the substances, Blanton recommends choosing floss without PFAS chemicals, such as silk floss with a wax coating.
Blanton also suggested finding ways to reduce your exposure to harmful chemicals in other products, not just floss.
“It is important to be aware of these ingredients as well as anything we ingest or consume throughout our day,” said Blanton.
Don’t Stop Flossing
Flossing your teeth is just as important as brushing when it comes to optimal oral hygiene.
The act of flossing helps remove food particles and plaque that get stuck between teeth and along the gum line—spots your toothbrush is likely to miss. Flossing helps reduce the risk of cavities and prevent gum disease. Given how effective it is as an oral hygiene tool, experts don't advise that people stop flossing.
“Flossing cleans surfaces in between your teeth that your toothbrush cannot access and dislodges stubborn food particles,” said Blanton. “Poor oral hygiene will lead to gingivitis and periodontitis, which has known links to heart disease.”
How to Choose a Safer Dental Floss
Blanton said to start by checking the ingredients listed on the floss you use. These are typically listed on the floss’s packaging, but if they are not, you can contact the manufacturer or search the brand online.
If you are looking to avoid certain ingredients, choose floss that is free from Teflon and petroleum-based materials. Instead, opt for silk or nylon floss, which are “considered the least likely to cause any harm,” said Blanton.
Chandrasekaran said there isn’t much difference between waxed and unwaxed floss in terms of what is better for your teeth. However, “unwaxed floss may be an alternative for patients who are concerned” because it tends to have fewer added ingredients and artificial flavors. If you prefer a wax coating, choose floss with a natural wax coating, such as coconut oil or beeswax, instead of synthetic versions, like petroleum.
Are There Alternatives to Dental Floss?
There are some other things you can do to maintain a healthy mouth besides flossing:
Water flossers or oral irrigators: These devices use water to remove plaque and debris between teeth and along the gum line. However, according to Chandrasekaran, these devices don’t remove plaque as well as traditional floss.
Interdental brushes: These small brushes are designed to clean between the teeth and around dental devices like braces or dental bridges.
Floss picks: Floss picks are usually disposable plastic tools that are flexible and can slip cleanly between the teeth, making them easier to use than traditional floss.
Air flosser: Air flossers use a handheld device that uses compressed air and micro-droplets of water or mouthwash to clean between the teeth and gum line.
“It’s important to remember that the best option is the one you will actually use!” said Blanton. “When choosing a dental floss, ingredients as well as lifestyle choices should be taken into consideration.”
According to Blanton, vegans may want to consider any animal products used in floss, such as silk, beeswax, and glycerin. On the other hand, some people might prefer using floss sticks, which are less bulky, instead of something like a Waterpik or traditional floss.
Chandrasekaran recommends working with your dental care provider to get personalized recommendations about oral hygiene products that meet your needs.