Cleaning between teeth is a crucial step in maintaining long-term oral health, a practice known as interdental cleaning. Brushing alone cannot effectively reach the areas where adjacent teeth touch, leaving behind plaque and food debris in these tight interproximal spaces. If this material is not removed, it leads to gingival inflammation and can progress into periodontal disease and the development of cavities.
String floss presents obstacles for many, including difficulty maneuvering the thin filament or general frustration that leads to inconsistent use. Physical limitations, such as limited manual dexterity or the presence of complex dental work like braces, bridges, and implants, also make traditional flossing impractical or ineffective. Fortunately, a range of specialized tools exists to make interdental cleaning easier and more effective for those seeking alternatives.
Water Flossers and Oral Irrigators
Water flossers, also known as oral irrigators, use a pressurized stream of water to clean between teeth and along the gum line. The device utilizes a motor-driven pump to create a pulsating water jet, operating on the principle of hydrodynamic cleaning. This rapid, focused pulsation creates turbulence that effectively disrupts bacterial colonies and flushes away food particles and soft plaque.
To use the device, fill the reservoir with lukewarm water and place the tip in the mouth before turning the unit on to prevent splashing. The user should lean over the sink, aiming the tip at the gum line at a near 90-degree angle, and then trace along the teeth. Pause briefly between each tooth, allowing the stream to penetrate the interdental space and flush debris before moving to the next area.
Start with the lowest pressure setting and gradually increase the intensity until a comfortable level is found. Water flossers are beneficial for individuals with orthodontic appliances like braces, as the water jet easily navigates wires and brackets, and for those with dental implants and crowns. The pulsating stream can also penetrate slightly below the gum line, making it effective for reducing gingival inflammation and bleeding.
Interdental Brushes
Interdental brushes are small, specialized cleaning tools featuring bristles attached to a fine wire handle, designed to mechanically sweep away plaque from the sides of the teeth. These brushes are often considered superior to string floss for plaque removal and reducing gingival bleeding, especially in people with open spaces between their teeth. They are highly effective at disrupting the biofilm.
Selecting the correct size for each gap is the primary factor for effective use, as the space between teeth can vary significantly across the mouth. The brush should fit snugly, allowing the bristles to engage and clean both tooth surfaces and the gum tissue, but the wire core must not rub against the teeth. Forcing a brush into a space that is too small can cause trauma to the gum tissue, while a brush that is too loose will not effectively remove plaque.
Users may require two or three different sizes; starting with a mixed sample pack can help determine the correct fit for each area. Once the correct size is chosen, insert the brush gently into the space and move it horizontally back and forth several times, cleaning the entire length of the interdental area. For accessing the back teeth, the brush handle can be slightly bent near the neck, which enhances maneuverability.
Dental Picks and Stimulators
Dental picks and stimulators are simpler, manual interdental aids focusing on localized cleaning and gum health. Dental picks are typically small, disposable, stick-like tools made from plastic, wood, or soft rubber. Their primary function is to remove larger food debris and soft plaque from the spaces between teeth, especially after meals.
Soft rubber stimulators, often attached to the end of a toothbrush, have a pointed, flexible tip. These tools are used to gently massage the gum tissue along the gum line, which can help increase blood flow and promote tissue firmness. The stimulator is angled at about 45 degrees to the gum and tooth surface and moved with a gentle circular or back-and-forth motion.
While excellent for quick cleanings and gum massage, picks and stimulators generally do not offer the comprehensive plaque removal of interdental brushes or water flossers. They are particularly useful for individuals with wider gaps between teeth or those with receding gums, where the soft tip can access areas that a toothbrush cannot. The use of these tools should be gentle, as excessive force can irritate the gums or damage the enamel.