Why flossing doesn’t help your teeth

...oh, and cough syrup’s a waste of time and fish oil doesn’t help hearts. Our experts reveal the popular treatments that don’t make a difference

loss of bone after the menopause but only to marginal effect,’ he adds. However, he says those with established osteoporosis may still need calcium supplementation along with vitamin D and their bone-strengthening medication. ACUPUNCTURE FOR BACK PAIN Acupuncture is no longer recommended as a treatment for low back pain on the nHS following a review of evidence that found it’s no better than a placebo.

However, George Lewith, a professor of health research at Southampton university, says he is ‘completely at a loss’ as to how this conclusion was reached, especially as the same data is interpreted in a different way in other countries.

But professor conaghan points out that cost effectiveness comes into decisions by nIce (national Institute for Health and care excellence), too. ‘It looks at efficacy first, and cost effectiveness second. neither of these points made acupuncture look particularly attractive.’ FISH OIL FOR YOUR HEART OmAcOr is an omega 3 fish oil supplement that Gps often prescribe to patients with heart dis- ease, angina, or who have had a heart attack says Sundip patel, a consultant cardiologist at the London Bridge Hospital.

‘At one point it was thought to be beneficial to heart health,’ he says. the capsules, which cost around £21 for a month’s supply, were thought to help by reducing the levels of triglycerides or blood fats.

Dr patel says: ‘evidence has since shown there is no benefit from taking it, but patients still ask for it.’

A study in 2012 in the Journal of American medical Association analysed the outcome of 68,000 people taking fish oils (1.5g a day) or a placebo for two years. those taking oils did not have statistically fewer heart attacks or less heart disease than those not taking them.

nIce recommends that doctors tell people: ‘there is no evidence that omega 3 fatty compounds help to prevent coronary heart disease.’ ANTIBIOTICS FOR EARACHE One in four children suffers an ear infection (otitis media) by the age of ten. research carried out at Southampton university shows ear infections are the most common reason for children being prescribed antibiotics by their Gps.

In fact two in three ear infections are caused by viral infections, which antibiotics are powerless to treat, says professor tony nerula, president of the ear, nose and throat specialists’ body ent uK. Only about one in three is caused by bacteria.

A viral infection usually clears up on its own within 48 hours, and patients are advised simply to take paracetamol or ibuprofen.

‘the problem is Gps have no way of knowing if a virus or bacterium is the cause,’ says professor nerula. ‘ So most issue a deferred prescription for antibiotics dated for a couple of days’ time. the parent is told to collect the prescription if the infection does not clear up by then.’ ASPIRIN FOR A FAULTY HEARTBEAT ArOunD one million people have atrial fibrillation, an irregular and often abnormally fast heartbeat. It can raise the risk of blood clots forming in the heart’s chambers, causing a stroke.

even though research shows aspirin is not beneficial in atrial fibrillation patients, some are still given it, says cardiologist Klaus Witte. ‘Aspirin does have a marginal blood-thinning effect but this is probably ineffective in preventing the type of clot that causes a stroke in atrial fibrillation.’

these patients should instead be prescribed an anticoagulant — medicines to prevent clots — such as warfarin, or one of three newer drugs, apixaban ( eliquis), dabigatran (pradaxa) or rivaroxaban (Xarelto). Yet the results of a small survey last year by the Atrial Fibrillation Association suggested 200,000 patients are still being given aspirin. HIGH-FIBRE DIET FOR IBS FOr many years increasing the amount of bran in the diet was the main advice given to those with irritable bowel syndrome. Yet there was no evidence it worked.

‘In fact for many patients it made the symptoms worse. there was never any evidence that it would work — it just became a widespread belief,’ says professor chris Hawkey, a gastroenterologist at nottingham university who is also chairman of cOre, the charity for those with diseases of the gut, liver and pancreas. MILLIONS rely on paracetamol for everyday aches and pains. But when it comes to certain conditions we may be wasting our time.

Last year, a review of 13 clinical trials, published in the British medical Journal, found it ineffective for back pain and, when it comes to osteoarthritis of the hip and knee, the improvement was so small that it was ‘not clinically important’.

Instead the experts, from the university of Sydney, warned the drug could cause liver problems.

A more recent comprehensive study, published in the Lancet in march, found paracetamol had ‘no role’ in treating the joint pain of osteoarthritis. ‘It’s disappointing, but patients have been telling us for years that they are not impressed with paracetamol,’ says prof philip conaghan.

non-steroidal anti-inflammatories seem to be more effective, he says, but many people cannot take these long term and they can have significant side-effects.

He says that what does seem to help with both problems is strengthening muscles, but this takes time. STATINS FOR THE ELDERLY STATINS are the most commonly prescribed drugs in the uK — many millions of people take them to help cut their levels of LDL or ‘ bad’ cholesterol, which is thought to clog arteries and increase the risk of heart attacks and stroke.

there is evidence statins can reduce the risk of heart attacks and stroke, especially among those who have had a major event such as a previous heart attack.

‘Yet sometimes these drugs are given to people in their 80s or older who have not had a previous major event and there is very little if any research to suggest that it is of benefit to them,’ says professor Simon maxwell, consultant pharmacologist at the university of edinburgh.

‘most research has been done on far younger people who have had a major event.’ Statins are linked to side-effects such as muscle pain. Interviews by: Danny Buckland, Lucy Elkins, Pat Hagan, Jinan Harb and Diana Pilkington

PARACETAMOL FOR BACK PAIN/ARTHRITIS