Cleaning between teeth is a necessary part of daily oral hygiene to remove plaque. Traditional string floss has long been the standard for this interdental cleaning process. However, the rise of the water flosser, also known as an oral irrigator, introduces a different method that uses a pressurized stream of water. This device raises a frequent question: Can water flossing fully replace the mechanical action of string flossing in a regular routine?
How String Flossing and Water Flossing Clean
Traditional string flossing works through a physical, mechanical scraping action. The floss is manually threaded between the teeth and wrapped in a “C-shape” around the tooth surface. This allows it to physically rub off the sticky bacterial biofilm, or plaque, from the sides of the teeth and slightly below the gumline. This technique requires manual dexterity and contact with the tooth surface to disrupt the tightly adhered bacterial colonies.
Water flossing operates on hydro-kinetic action instead of physical contact. The device emits a targeted, pulsating stream of pressurized water to flush out loose debris and disrupt bacterial colonies. This fluid displacement mechanism allows the water to penetrate and clean areas that string floss might struggle to reach, such as irregular interdental spaces or the shallow periodontal pocket. The stream effectively rinses away food particles and soft plaque.
Clinical Efficacy: Comparing Plaque Removal and Gum Health
Clinical studies comparing the two methods show that water flossers are effective and can sometimes outperform string floss. One study found that when paired with a manual toothbrush, a water flosser was significantly more effective at removing whole-mouth plaque than string floss, showing up to a 29% greater reduction in overall plaque. The pulsating water stream is highly effective at disrupting the biofilm structure and flushing out bacteria from hard-to-reach surfaces.
Water flossers demonstrate effectiveness for reducing gingivitis and gum bleeding. The gentle flushing action can clean deeper into the gum pockets without the potential trauma that incorrect or aggressive string flossing might cause. This makes the water flosser an excellent tool for managing early stages of gum disease, as it reduces inflammation and removes bacteria from the gum margin.
Despite the strong clinical findings supporting water flossers, string floss remains the gold standard for the mechanical removal of plaque directly adhered to the tooth surface. The dental community often views the two tools as complementary. String floss provides the friction necessary to shear off tightly bound biofilm, and the water flosser excels at flushing and reducing inflammation. The most effective routine for many individuals may involve incorporating both methods for optimal cleaning, though a water flosser can be a suitable replacement for those who refuse to use string floss.
When Water Flossers Are Recommended
Water flossers are often highly recommended and can be superior to string floss in specific circumstances involving complex dental work or physical limitations.
Orthodontics and Restorations
For individuals with orthodontics, such as braces or fixed retainers, the pressurized stream can clean around wires and brackets where threading string floss is tedious or nearly impossible. Studies show that water flossers with specialized orthodontic tips lead to less plaque and bleeding in these patients compared to traditional flossing methods.
Individuals with complex restorations like dental implants, bridges, or crowns also benefit from the flushing action. The water stream can navigate the prosthetic structure to clean areas that string floss cannot easily access, such as under bridges or around implant abutments. This targeted cleaning is instrumental in preventing peri-implant disease.
Dexterity and Sensitivity
The water flosser is also a preferred tool for people who struggle with the manual dexterity required for effective string flossing. Those with conditions like arthritis or limited hand mobility often find the handheld device easier to use. For sensitive gums or deep periodontal pockets, the gentle, non-contact cleaning of a water flosser can reduce irritation while providing thorough subgingival cleaning. To maximize the cleaning effect, use warm water and aim the stream perpendicular to the gumline.