Dental professionals recommend daily interdental cleaning to maintain oral health. This practice removes plaque and food debris from areas a toothbrush cannot effectively reach. Many people wonder if this recommendation translates into widespread practice. This article addresses the habits of the general population and explores why this step remains necessary for complete oral hygiene.
The Current State of Flossing Habits
The statistics indicate that daily flossing is not a habit adopted by the majority of the population. Recent data from the National Health and Nutrition Examination Surveys suggest that only about one-third of adults in the United States report flossing every day. This means that for every person who performs this cleaning action daily, two others are either flossing occasionally or skipping the practice entirely.
The frequency of interdental cleaning varies significantly across different groups. Adults aged 45 and older, women, and individuals with a higher income-to-poverty ratio are associated with a higher likelihood of flossing daily. Conversely, individuals with lower oral health literacy or lower incomes often report lower rates of regular flossing. Approximately 32% of adults report not having used floss or any interdental device at all in the past week.
Why Flossing Remains a Recommended Practice
Cleaning between the teeth is necessary because a toothbrush can only reach the outer, inner, and chewing surfaces of the teeth. Bristles cannot effectively access the 40% of the tooth surface area located in the tight spaces between adjacent teeth or just beneath the gumline. This interproximal space is where food particles and plaque, a sticky film of bacteria, accumulate undisturbed.
If interdental plaque is not mechanically disrupted and removed daily, it initiates a localized inflammatory response called gingivitis. This initial stage is characterized by gums that may appear red, swollen, or bleed easily when brushed. Over time, plaque can absorb minerals from saliva and harden into tartar, or calculus, which only a dental professional can remove.
The prolonged presence of tartar and plaque leads to the destruction of the tissues and bone supporting the teeth, a condition known as periodontitis. Periodontitis results in receding gums, deepening periodontal pockets, and eventually tooth loss. Therefore, interdental cleaning is recommended as a preventative measure against the progression of gum disease and tooth decay in these vulnerable areas.
Addressing Barriers: Alternatives and Techniques
One of the main reasons people skip traditional string flossing is the difficulty with technique, particularly in reaching the back teeth, or the perceived time commitment. For those who find string floss awkward, especially individuals with limited dexterity, alternative interdental cleaning tools offer a practical solution.
Interdental brushes are small, cone-shaped brushes designed to fit snugly between the teeth. They are often considered superior to floss for people with larger spaces or receding gums. The brush size must be chosen so it fills the space without being forced, and it should be inserted and moved back and forth a few times to clean the entire interdental area. These brushes are an excellent choice for cleaning around dental work like braces or fixed bridges.
Water flossers, or oral irrigators, use a pressurized stream of water to flush out debris and plaque from between teeth and beneath the gumline. This method is particularly beneficial for individuals with extensive dental restorations, implants, or orthodontic appliances. The proper technique involves aiming the stream at a 90-degree angle to the tooth surface, tracing the gumline, and pausing briefly between each tooth.
Floss picks, which are small plastic tools with a segment of floss pre-strung, address the dexterity issue by providing a handle. While they are convenient for on-the-go use, they do not allow the user to wrap the floss around the tooth in the C-shape recommended for string floss. This makes them less effective at cleaning the entire side of the tooth and below the gumline.