HOLMDEL, N.J. — It's one of the most universal recommendations in all of public health: Floss daily to prevent gum disease and cavities.

Except there's little proof that flossing works.

Still, the federal government, dental organizations and manufacturers of floss have pushed the practice for decades. Dentists provide samples to their patients; the American Dental Association insists on its website that, “Flossing is an essential part of taking care of your teeth and gums.”

The federal government has recommended flossing since 1979, first in a surgeon general's report and later in the Dietary Guidelines for Americans issued every five years. The guidelines must be based on scientific evidence, under the law.

Last year, the Associated Press asked the departments of Health and Human Services and Agriculture for their evidence, and followed up with written requests under the Freedom of Information Act.

When the federal government issued its latest dietary guidelines this year, the flossing recommendation had been removed, without notice. In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched, as required.

The AP looked at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings? The evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.”

“The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal,” said one review last year. Another 2015 review cites “inconsistent/weak evidence” for flossing and a “lack of efficacy.”

One study review in 2011 did credit floss with a slight reduction in gum inflammation — which can sometimes develop over time into full-fledged gum disease. But reviewers ranked the evidence as “very unreliable.” A commentary in a dental magazine stated that any benefit would be so minute it might not be noticed by users.

The two leading professional groups — the American Dental Association and the American Academy of Periodontology, for specialists in gum disease and implants — cited other studies as proof of their claims that flossing prevents buildup of gunk known as plaque, early gum inflammation called gingivitis, and tooth decay.

But most of these studies used outdated methods or tested few people. Some lasted only two weeks, far too brief for a cavity or dental disease to develop.

Wayne Aldredge, president of the periodontists' group, acknowledged the weak scientific evidence and the brief duration of many studies. He said that the impact of floss might be clearer if researchers focused on patients at the highest risk of gum disease, such as diabetics and smokers.

Still, he urges his patients to floss to help avoid gum disease.

When asked for proof of its claim that flossing helps prevent early gum disease and cavities, the ADA cited the 2011 review and a 2008 two-week study that measured bacteria and did not even consider gum disease.

In a later statement to the AP, the ADA said flossing “removes plaque” and “is proven to help remove” debris from between teeth. A video on its website proclaims that flossing “helps prevent gum disease.” When pressed, Matthew J. Messina, a practicing dentist and spokesman for the dental association, acknowledged weak evidence, but he blamed research participants who didn't floss correctly.

Even companies with a big market share of the flossing business struggled to provide convincing evidence of their claims that floss reduces plaque or gingivitis. Yet the industry has paid for most studies and sometimes designed and conducted the research.