Interdental cleaning - Dental floss vs. Water pick vs. Interdental brushes

June 11, 2016

Interdental cleaning - Dental floss vs. Water pick vs. Interdental brushes
Dental floss is used for cleaning plaque and debris in between teeth.
Interdental brushes are used to clean the gaps in between teeth. They come in different colors and sizes.
Water pick is also known as oral irrigator and water flosser. It is a device for cleaning the plaque and debris in between teeth by flushing it out.

A healthy mouth requires proper oral hygiene routines at home. The American Dental Association (ADA) suggests you brush at least twice a day and clean between teeth at least once daily. This helps remove plaque, bacteria, and food particles to keep teeth and gums healthy. Most patients can manage brushing twice daily, but many still struggle with cleaning between teeth. This could be from a lack of time, convenience, or ability. Fortunately there are several interproximal tools to choose from. Most people are familiar with floss, but don’t realize there are other options. If you struggle with consistently cleaning between your teeth, one of these interdental cleaners might be a practical alternative.


Dental Floss

This is a flexible, often waxy strand of plastic or nylon filaments. It works to mechanically remove plaque and food caught between teeth all the way down to the gumilne. It comes in different thicknesses, coatings, and flavors. You can even choose eco-friendly options with biodegradable and renewable silk floss and vegan waxes.

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How to use dental floss

Here are the steps to follow:

  1. Pull about 18” of floss from the spool
  2. Wrap the excess around middle fingers
  3. Hold floss between thumbs and index fingers of both hands
  4. Gently slide floss between teeth, do not snap it into the gums
  5. Wrap floss against the edge of a tooth to form a “C” shape
  6. Use gentle up and down motions to clean the area
  7. Glide floss gently into the gumline
  8. Repeat with each surface of each tooth
  9. Upon completion, rinse your mouth and throw away the floss

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Pros and cons of dental floss

Floss can fit between the tightest spaces with ease and there is no need for lubricant. You can use it without a mirror and without a sink. With floss there is little chance of damage to the soft tissue, even with some excessive pressure. This option is also sterile, as you only use a piece of floss once before throwing it away. Patients can clean the entire side of each tooth, and not just teeth with gaps between them. Floss is great for flat surfaces, but not for concavities between teeth. Also, for many people, flossing isn’t easy due to a lack of mobility or dental appliances. Floss can leave behind a waxy coating that can harbor more plaque. And though the most affordable option, dental floss is also wasteful. One person would use up approximately 5 miles of floss in a lifetime, if they kept up the habit every day.

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Water Pick

Also known as an oral irrigator or dental water jet, this device uses a powerful stream of water to flush out plaque and bacteria. These use a pulsating stream of water between 5 to 90 psi of pressure. They consist of a tank and pump, a handle with a button to release the water, and a tip to direct the flow of the tight stream.


How to use water pick

These are the steps to follow:

  1. Fill reservoir with warm water, and place it on the base
  2. Choose the right tip and attach to the handle
  3. Start with the pressure control on low, and work your way up to a medium pressure
  4. Lean over the sink and place the tip inside mouth
  5. Turn the unit on
  6. Start cleaning on and around back teeth of upper jaw
  7. Aim tip at a 90 degree angle just above gumline
  8. Work your way to the front, pausing briefly between each tooth
  9. Repeat with bottom teeth


Pros and cons of a water pick

A water pick is often a gentler option, and is twice as effective as floss at reducing gingival bleeding. It removes dental plaque, though not as efficiently as floss, and reduces the patient’s risk of gingivitis. Dentists often recommend this device for patients with several major restorations, orthodontics, or those who struggle with routine flossing. It also works well for patients with chronic gum disease or gum sensitivity. However, these products are expensive compared to floss. You must change the tip every 3 to 6 months. They are also messy to learn how to use, as water can spray everywhere. Lastly, if used at too high a pressure, the water pick could inadvertently force food deeper into the soft tissue instead of removing it.


Interdental Brush

This is often a thin, cone or round shaped brush with a small head. The bristles connect to a thin wire attached to a small, or uniquely shaped handle, to help you clean gently between teeth. The brushes come in a variety of sizes and are designed and manufactured to fit gently between teeth. The brush should glide smoothly, without having to force it or feel tight. If the smallest brush does not fit comfortably between teeth, then the patient should use dental floss. Depending on the amount of space between teeth, patients might use one size for front teeth and a different size for back teeth. An interdental brush works much like a normal tooth brush. Patients should rinse it after use and replace it when bristles wear out.


How to use interdental brushes

These are the steps you should follow:

  1. Brush in front of a mirror
  2. Lubricate the brush with water, paste or gel
  3. Hold the brush like a pencil
  4. Start on top rear and work your way around
  5. Slowly slide the tip into the interdental triangle (gap formed by the gum and two teeth)
  6. Slowly move it back and forth along the tooth surface 2 or 3 times, angling to clean both sides of both teeth
  7. When brushing molars, clean from both the inner and outer sides
  8. Continue to each gap between teeth, the repeat on the top
  9. Rinse your mouth and your brush with warm water


Pros and cons of interdental brushes

This interproximal device is especially handy for patients with larger spaces between teeth. These gaps make it difficult to use dental floss properly, and the brush is more effective. This brush is also good for patients with limited mobility or braces, because the tool is easier to maneuver. It can also help clean between restorations like dentures, bridges, and implants. Patients like the interdental brush because they only need the use of one hand. Some of the disadvantages are these brushes are more expensive than floss, they require wetting or lubrication before use, and the wire center can damage the gums. Also, after one use, the brush will never be completely sterile. These brushes are also more likely to cause irritation to the gums.


What do you choose?

If you hate to floss, or are incapable of maneuvering the tiny string in your mouth, talk to your dentist about interdental brushes or a water pick as a solution. These products are easy to use and backed by decades of research. Even if you are a regular flosser, you might consider a water pick or interdental brush to compliment your hygiene routines. If you don’t know how to use any of these tools, talk to your dentist or hygienist. They will give you proper instruction and help you find the right solutions for your individual needs. 


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