Cleaning between your teeth is a necessary step in daily oral hygiene, typically done using string floss or a water flosser (oral irrigator). Both methods aim to remove the sticky bacterial film known as plaque and food debris from tight spaces that a toothbrush cannot reach. Understanding how each device cleans the tooth surface and the gum line is the first step in deciding which method is best for your individual needs.
Understanding the Cleaning Mechanism
Traditional string floss cleans through a direct mechanical action. The user manually scrapes the sides of the teeth and slides the material just beneath the gum line in a “C” shape, physically disrupting and lifting off plaque biofilm. This method requires a certain degree of manual dexterity and a specific technique to ensure all interproximal surfaces are contacted and thoroughly cleaned. The quality of the clean is highly dependent on the user’s ability to maintain the correct technique for every tooth.
A water flosser operates on a completely different principle, using a pressurized stream of pulsating water to clean between the teeth and around the gums. This device directs a rapid series of water pulses, creating a hydrodynamic force that flushes out loose particles and disrupts the bacterial colonies. The water stream does not rely on physical scraping but instead uses this hydrokinetic energy to clean, making the technique less dependent on precise hand movements. The stream can often reach deeper into periodontal pockets compared to string floss, aiding in the removal of bacteria from hard-to-access areas.
Clinical Efficacy: Plaque and Gum Health
For immediate plaque removal, especially on the flat surfaces of the tooth where the floss makes direct contact, string floss used perfectly remains highly effective. However, clinical trials show that water flossers are at least as effective as string floss in removing interdental plaque, with some studies indicating superior results. For example, one study found a water flosser was 29% more effective than string floss for overall plaque removal.
When evaluating gingival health, measured by indicators like bleeding and inflammation, water flossers often demonstrate a distinct advantage. The pulsating water jet is highly efficient at flushing bacteria and toxins from the sulcus, the shallow groove between the tooth and the gum. Clinical data has shown that a water flosser can be up to 93% better at reducing gingival bleeding and over 50% more effective at reducing gingivitis compared to string floss. This suggests that while string floss physically scrapes surface plaque, the water flosser is more proficient at managing the overall bacterial load that drives gum disease.
The pressurized water stream can penetrate deeper into the periodontal pockets than string floss. This ability to clean subgingivally is a significant factor in reducing inflammation and improving the clinical attachment level around the teeth. Therefore, for the specific goal of reducing gingivitis and improving the overall condition of the gums, water flossers show superior clinical outcomes when used as an addition to brushing.
Practical Factors and Specific Patient Needs
Practical elements like ease of use and cost influence the choice between the two methods. String flossing has a steep learning curve; incorrect technique can be ineffective or even cause gum irritation, and it requires significant dexterity. A water flosser is considered easier to use, which is a major benefit for individuals with limited hand movement, such as those with arthritis. The reduced technique sensitivity often leads to better patient compliance and more consistent results. String floss involves a low initial investment and is highly portable, versus the higher upfront cost of a water flosser, which can be a long-term, cost-effective tool.
For patients with orthodontic appliances like braces, the water flosser is often the recommended cleaning tool. The stream easily navigates around wires and brackets to flush out trapped food and plaque, a task that is tedious and difficult with string floss. Similarly, for individuals with dental implants, bridges, or crowns, water flossers are highly beneficial and often more effective than traditional floss. The device is gentler on the sensitive tissues surrounding implants and can significantly reduce bleeding in these areas.