DETROIT – What is the best way to clean between your teeth? We are talking about flossing, using an interdental brush or pick, or using a WaterPik. I really want to be clear about this because what I do is not what the American dental societies recommend. Here’s the issue: there is a natural buildup of biofilm on and between our teeth. This biofilm is a thin layer of slime made of bacteria, food debris, and other components. The only truly effective way to remove a biofilm is with direct mechanical abrasion. When we brush our teeth, the outer surfaces get that direct abrasion, but the spaces between our teeth do not. That’s why we need to specifically clean between our teeth. According to Dr. Joseph Nemeth, a Southfield periodontist, if you do not floss you are taking years off your life due to the inflammation of your gums.
Dental floss is very effective, and it is the recommended method of cleaning between your teeth by the American Dental Associations. I will say this: if you are able to floss properly and you do it regularly, you should by all means continue to floss. According to Dr. Nemeth when you floss you should curl the floss around the tooth and gently slide it up and down to just beneath the gum line to remove the biofilm and any plaque, do that on both sides of the space between the teeth. You should be sure to reach all of the spaces between all of your teeth. As far as the choice of floss, he recommends using whatever is most comfortable and convenient for you.
Personally, I find flossing tedious and a bit of a challenge to do correctly, so I investigated alternatives. As it happens, there is solid research behind the primary alternative to flossing: the interdental brush or pick. These little reusable brushes slip between your teeth and remove debris and, most importantly, this slimy biofilm. They are bendable and allow you to get to all your teeth, even the back ones. And most important to me, they are easy to use and very portable for use, even after lunch, as an example. The research on their effectiveness is strong enough that the British Society of Periodontology and other European agencies actually recommend the use of interdental brushes over flossing. I know this is where people might make a joke about British teeth, but regardless, there is good science behind the recommendation.
Now, we need to address the WaterPik. I love mine and cannot go without it. Every time I use it, even after I’ve thoroughly brushed, I still get debris and food particles flushed out. The biggest thing the WaterPik does that floss and interdental picks do not is, in addition to cleaning between your teeth, it also flushes out the pockets between your gums and the base of your teeth. This is another area where food and gunk can accumulate. Not everyone has deep pockets, meaning their gums are nice and snug at the base of their teeth, but depending on your genetics and how well you cared for your teeth when you were younger, many people develop deeper pockets as they age. That’s where a WaterPik excels. Here’s where I want to be crystal clear: a WaterPik by itself will not remove the biofilm between teeth. It is not an adequate direct mechanical abrasion, and a WaterPik shouldn’t be your sole method of cleaning between your teeth.
The TL;DR is: floss if you can do it right, use an interdental pick or brush if you don’t floss, and use a water pick if you have deep pockets and get joy, like I do, from seeing extra debris cleaned out.