Skipping interdental cleaning, even with diligent toothbrushing, leaves behind significant bacterial accumulation that brushing alone cannot address. This permits the constant presence of a sticky film of bacteria, known as plaque, in sheltered parts of the mouth. The immediate and long-term consequences of this retained plaque progress predictably, starting with localized inflammation and odor, and potentially leading to the destruction of tooth structure and supporting bone. Mechanical cleaning between the teeth is a necessary component of a complete hygiene routine.
The Areas Brushing Cannot Reach
A standard toothbrush is anatomically limited and can only reach about 60% of the tooth surfaces. The largest uncleaned area is the interproximal space, the tight, concave surface between two adjacent teeth. Bristles cannot effectively wrap around these convex surfaces, creating a sheltered environment for plaque to form undisturbed. The other vulnerable area is the gingival sulcus, the shallow crevice between the gum tissue and the tooth surface. This subgingival area quickly becomes colonized by bacteria inaccessible to the brush, driving the onset of nearly all common dental diseases.
Early Consequences: Inflammation and Odor
The immediate result of retained interdental plaque is gingivitis, a localized inflammatory response in the gum tissue. This condition arises as the immune system reacts to toxins released by accumulating bacteria in the gingival sulcus. Inflammation causes the gums to become red, swollen, and tender, often leading to bleeding when brushing or eating firm food.
A common side effect of this bacterial growth is persistent bad breath, or halitosis. Anaerobic bacteria thrive in the low-oxygen environment of the interproximal spaces and gum pockets, breaking down proteins and cellular debris. This metabolic process releases foul-smelling volatile sulfur compounds (VSCs), which are responsible for the unpleasant odor. Gingivitis is generally a reversible condition, but if the retained plaque is not eliminated, the condition will progress.
Serious Long-Term Damage: Decay and Bone Loss
If the interdental plaque is left undisturbed, the consequences progress beyond reversible inflammation to cause permanent structural damage to the teeth and their supporting structures. One significant issue is the formation of interproximal caries, cavities that develop on the sides of the teeth where they touch. Acid-producing bacteria within the sheltered plaque demineralize the enamel in these contact areas. These cavities are often difficult to detect early and may go unnoticed until the decay has penetrated significantly into the tooth structure.
The other destructive long-term result is the progression of gingivitis into periodontitis, an advanced form of gum disease. Chronic inflammation causes the immune response to attack the ligaments and alveolar bone that anchor the teeth. This process leads to the irreversible loss of bone structure and the formation of deeper pockets. As the disease advances, the teeth can become mobile, potentially resulting in the eventual loss of the affected teeth.