Are you aware of the importance of flossing teeth? Do you know the benefits? Is there a correct way to do it? What does it mean if your gums bleed? Let’s answer some of these common questions…
The Importance of Interdental Cleaning
Note – Interdental just means ‘between the teeth’
While brushing twice daily is of course essential, if you want a healthy mouth, unfortunately on it’s own it is not enough for a total clean. Brushing alone will leave around 40% of your mouth un-cleaned. Even by using the most thorough brushing technique, the spaces between the teeth will remain untouched. Added up, all these spaces come to a large percentage of the total tooth surface area that needs to be cleaned.
You know that you need to brush for the following benefits to your dental health:
Achieve a fresh, clean mouth
Reduce bad breath
Reduce the risk of gum disease, (the major cause of tooth loss and contributing factor to some health problems like heart disease)
Reduce the risk of dental decay.
So if you aren’t flossing, or using an alternative, then you are leaving a large area of the mouth un-cleaned. These tooth surfaces will have a large amount of plaque build-up and food debris. Your oral health will suffer, ie you are at increased risk of developing the above problems
So You Need to Clean ‘Interdentally’. What are the options?
There are a few ways:
- Using dental floss, the most common and effective way for most people. Dental floss is nylon string. It can be either unwaxed or waxed, to help it run smoothly between the teeth. Dental tape is also available. It is essentially a thicker type which many people may find easier to use
- Interdental brushes, used when there are slightly larger gaps
- Oral irrigator. This piece of kit uses a gentle stream of water to clean between the teeth. They can be very useful in some circumstances. See more here on water flossers.
Whatever method you need to use, it may take some time to master an effective and thorough cleaning technique. Practice makes perfect! Stick with it for much better oral health in the long-term.
You should clean interdentally at least once a day. It is best done at night if you are only able to do it once a day. Every space needs to be cleaned. In terms of flossing teeth before or after brushing, it is best to brush second (as recommended by the ADA). Doing this allows the ingredients in toothpaste to get into the spaces you have just debrided! You can then use mouthwash after brushing.
Some patients have expressed an unwillingness to floss for fear of removing fillings. If a filling comes out, it was going to come out soon anyway! You will do more harm in the long term by not using it.
One important point to note: If you have not cleaned interdentally in a long time, you may find it impossible to do so. This will be due to a build-up of hard tartar in the spaces. Tartar fills the spaces so it is not possible to pass floss etc. between them. Therefore visit your dentist for a thorough professional cleaning to enable proper effective home cleaning. Your dentist/hygienist will also advise you on how best to clean between your teeth.
Like all new skills, learning how to floss can take some time and practice. We’ve got a brief run-through of how to use dental floss here.
Which Type of Dental Floss to Use?
There are many types of string floss available. Which one you use is more about personal taste and ease of use than any other benefits. Try different types until you find which one you are most comfortable using. Variations include:
- Waxed vs. unwaxed. If waxed, may be easier to pass into the spaces
- Flavored or unflavored . Which you use is up to your preferences. Flavor has no effect on how well it works
- Fluoride–containing or not. Fluoride is of course useful in strengthening the teeth. Although string will not deliver much fluoride, it can only be a good thing to have a little extra to help
- Thread/string-type vs. thicker tape-type. Some may find the tape type easier to use, especially while learning. Again, try out different types to see which works best for you
- Traditional roll of string/tape vs. ‘holder‘. The holder may make things easier but will cost you a lot more over time.
Alternative Flossing Tools
Traditional floss is not ideal for everyone, however it is still important to use some sort of interdental cleaner daily. An alternative may be advised by your dentist/hygienist. For example if you have:
- Problems with dexterity
- Gaps between the teeth that are too large for thin floss to clean effectively
- Bridges or implants - These treatments can result in spaces that are difficult to negotiate with tape or string.
Firstly, using a holder may improve your ability to use floss. Holders help remove some of the difficulty involved with the process of flossing, especially if you have problems with dexterity.
If you do have larger gaps between your teeth, due to the way your teeth lie or as a result of receding gums. Here inter-dental brushes (like ‘Tepe’ brushes, pictured below) are more effective than string or tape.
In such situations oral irrigators may be useful. These are new devices that are used at home. They provide a small jet of water which, when fed between the teeth, removes plaque and debris. Oral irrigators are particularly useful when other physical methods are not are effective. For example, the small hard-to-clean spaces around orthodontic appliances will be easier to clean with a stream of water than with floss or inter-dental brushes. See more review of the Waterpik flosser here.
An alternative ‘electric flosser’ is the Philips Sonicare Airfloss. This tool uses a ‘microburst’ of air and water to clear plaque and debris. It seems like a great product, but there are mixed consumer reports on it’s effectiveness. I’d recommend a Waterpik over this.
Some other interdental cleaners:
Bleeding Gums When Flossing
To begin with (if you haven’t done cleaned interdentally in a while), you may notice some bleeding. Some patients have used this as a reason to give up; they think the flossing itself is the cause. This is not the case, and will cause bleeding only when the gums are inflamed (gingivitis is present). The main reason why gums bleed is gum disease. Healthy gums will not usually bleed when you floss properly.
Any bleeding should subside within a week or two. This is because removing the plaque removes the cause of gum disease (and therefore gum bleeding).
If bleeding persists, contact your dentist. This may be due to a build-up of tartar which can only be removed my professional cleaning.
Flossing In a Nutshell
Flossing your teeth, or using another method to clean interdentally is an essential element of any oral hygiene routine. It is necessary in order to guard against gum disease, tooth decay and bad breath.
As always if you have any queries; consult your dentist/hygienist regarding your dental hygiene and for the best way to clean between your teeth.
A brief run-through of how to use dental floss here