Lance's Corner

NIH Issues Research on Using Dental Floss to Deliver Vaccines

Aug 19, 2025

Per the notice below, the National Institutes of Health (NIH) has issued research on using dental floss to deliver vaccines.

Floss-based vaccine shows early promise

At a Glance

  • Researchers found that a dental floss-based vaccine stimulated strong immune responses in mice against influenza.
  • Floss picks coated with a dye also successfully delivered the dye to gum tissue in people.
  • Floss-based vaccines may one day offer a simple, needle-free way to protect against a wide range of viral infections.

Although much more development is still needed, vaccines delivered via dental floss could have many benefits.

Vaccines are one of the best ways to protect against infectious illnesses, from influenza to shingles.  Most vaccines are given in the form of one or a series of shots.  While injectable vaccines are generally safe and effective, there’s interest in exploring needle-free alternatives.  Earlier studies have suggested the mouth could be a good place for delivering vaccines.  Vaccines delivered to the mouth might trigger immunity not only in the bloodstream but also in the mucosal tissues that line our body surfaces.  Those surfaces are where viruses often enter.  But attempts to deliver vaccines to the cheeks or under the tongue have had mixed results.  In a new study, researchers led by Dr. Harvinder Singh Gill at North Carolina State University wanted to test the potential for a vaccine delivered instead to the gums.  They focused on the gingival sulcus, the tiny groove between the teeth and gums.  The base of the gingival sulcus has a thin lining of tissue called the junctional epithelium.  Because the junctional epithelium is leakier, or more permeable, than other tissues, they thought it might be possible to deliver an effective immune-boosting vaccine there using dental floss.  Their findings appeared in Nature Biomedical Engineering on July 22, 2025.  The scientists coated flat tape dental floss from a local pharmacy with a variety of vaccine molecules and used it to floss the tiny teeth of mice in the lab.  They found that the compounds, including peptides, proteins, and inactivated influenza viruses, successfully transferred into gum tissue.  Floss coated with the influenza virus stimulated immune responses and the production of antibodies in the mice.  The researchers saw strong immune activity in multiple organs, plus antibodies in the bloodstream as well as the mucosal surfaces.  The team next tested whether the influenza vaccine protected mice from otherwise fatal infection with influenza.  The floss-based vaccine fully protected the mice.  It stimulated immunity better than a vaccine delivered under the tongue and about as well as one delivered into the nose.

“We found that applying vaccine via the junctional epithelium produces far superior antibody response on mucosal surfaces than the current gold standard for vaccinating via the oral cavity, which involves placing vaccine under the tongue,” says Rohan Ingrole at Texas Tech University, the study’s first author.  “The flossing technique also provides comparable protection against flu virus as compared to the vaccine being given via the nasal epithelium.”

“This is extremely promising, because most vaccine formulations cannot be given via the nasal epithelium—the barrier features in that mucosal surface prevent efficient uptake of the vaccine,” Gill explains.

To test whether a similar approach might work in people, the researchers coated off-the-shelf floss picks with fluorescent dye and tested them in 27 people.  They found that the picks successfully delivered dye into the junctional epithelium.  A survey of the participants suggested that the floss pick was well-received.  Floss-based vaccines could be a promising and practical alternative to injectable vaccines.  Needle-free and painless, they would require little preparation and wouldn’t need refrigeration, potentially making them cheaper and easier to distribute.  More study is needed to see how well they stimulate an immune response in people and whether they could be used in those with gum diseases.  The researchers note it’s also unclear whether the approach would work in young children who don’t yet have teeth.

—by Kendall K. Morgan, Ph.D.

Related Links

References

Floss-based vaccination targets the gingival sulcus for mucosal and systemic immunization.  Ingrole RSJ, Shakya AK, Joshi G, Lee CH, Nesovic LD, Compans RW, Gill HS.  Nature Biomedical Engineering.  2025 Jul 22.  doi: 10.1038/s41551-025-01451-3.  Epub ahead of print.  PMID: 40696115.

Funding

NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and National Institute of Dental and Craniofacial Research (NIDCR); Whitacre Endowed Chair in Science and Engineering at Texas Tech University.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc