Floss or Die
New Orleans was still the Big Easy. Hurricane Katrina would devastate the southern metropolis about a decade later, and my attendance of the annual meeting of my main professional society was a nice relief of the daily monotony at my dental school at home. I met many of my colleagues and I had a fantastic dinner on a Mississippi paddle steamer which was sponsored by a company with which I was working at that time.
It was one of the very first occasions that scientists in my discipline talked about a possible relationship between poor oral health and dangerous chronic conditions such as cardiovascular and cerebrovascular diseases. One of our most distinguished Professors in the field commenced his presentation with the message “Floss or Die”, a really frivolous statement. He later put the alleged relative risk for getting an infarction or stroke to 1.3 or so in case of more severe oral disease. It was the beginning of an endless discussion which mostly interested the numerous practitioners who, whithout any knowledge about odds or risk ratios, bothered their patients during the next decade with the menace of myocardial infarction, ischemic stroke, low birth weight, etc., if their oral diseases had not properly been treated. Most of this has vanished in the meantime and more realistic views have emerged.
What I didn’t know at that time was that the distinguished Professor in Oral Biology had just received an award in Economics. Not the real Nobel Prize but the “IgNobel Prize”. It stands for ignoble, and it is in fact a parody for achievements that “first make people laugh, and then make them think.” The chief sponsor of the prize is the Annals of Improbable Research which is a successor to a periodical that satirized scientific publications. That particular year, Jacques Chirac was among the laureates who, as the French President, had just launched a series of atomic bomb tests in the Pacific Ocean while the world was observing the 50th anniversary of the Hiroshima massacre. It was the Peace prize, of course. Understandably, he didn’t show at the ceremony in Harvard University’s Memorial Hall where the prizes were conferred about 2 months before the real ones each year since 1991.
Our distinguished Professor got the prize in Economics for his remarkable discovery that “financial strain is a risk indicator for destructive periodontal disease.” Of course, he didn’t accept the prize either but rather ignored the event. It was long before the financial markets went out of control, somewhat before the dot-com bubble emerged and finally burst in 2000. People at risk for gum disease (according to our Professor those in financial trouble) have not participated in either bubble, I suppose.
All of this is certainly not related to the decline of periodontal disease which has been observed over the last decade or so. A slide with “Floss or Die” is still in use to attract the interest of my undergraduate and graduate students. But as ever, more as a joke than a serious suggestion.
First published at Freelance.
Periodontology 
“I know that most men, including those at ease with problems of the greatest complexity, can seldom accept even the simplest and most obvious truth if it be such as would oblige them to admit the falsity of conclusions which they have delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives.”
-Tolstoy
Same is true for the perio/systemic links: they were woven, thread by thread, into the fabric of practices even though the links were and remain WEAK.
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