You know the standard advice that you should floss every day as well as brush twice a day as part of a good oral hygiene routine. But you’ve probably also heard that there is little evidence to support the benefits of flossing your teeth.

Now a new study is trying to clear up the confusion by evaluating nearly 2000 studies to figure out what the evidence tells us about cleaning between your teeth. Because of the number of disparate results, they couldn’t recommend a single method for cleaning between teeth as being better than the others. Instead, they recommend that dentists take a personalized approach to the question and recommend the type of cleaner that would work best for each patient.

attractive woman brushing with an electric toothbrush while watching herself in the mirror

Compiling Diverse Results

This review looked at a total of 1860 studies published from January 2008 to April 2019. This included six systematic reviews.

One of their main conclusions from looking at the data was that the studies were very diverse and couldn’t be easily synthesized. Plus, the evidence tended to be of low quality, from weak to moderate with generally low certainty of benefits.

However, in all the studies they saw some evidence of benefits, which made researchers believe that all of them could be effective under the right circumstances. Therefore dentists should work individually with patients to match them with their best tooth cleaning option.

Insights on Different Strategies

Among the 1860 studies that researchers looked at were six systematic reviews. Systematic reviews attempt to consolidate similar studies to create a single, larger study with greater statistical power to make better conclusions.

These systematic reviews came up with different conclusions. For example, the review focused on flossing used 11 studies to conclude that there was no evidence that flossing plus toothbrushing was better than brushing alone. However, another review, which looked at 22 studies, concluded that “unsupervised flossing” offered no benefits. This gets to the heart of the issue with flossing: it’s hard to do right. Many people might not know how to floss properly and therefore get no benefit from it.

On the other hand, three reviews (with 9, 22, and 35 studies, respectively) highlighted the benefits of interdental brushes. It claimed that they could remove more plaque, reduce bleeding, or both. The largest review also concluded that interdental brushes might be better than flossing. Water jets also scored high in several of the reviews. Even toothpicks were able to show some benefit in one of the reviews.

Why Do You Need to Clean Between Your Teeth and Gums?

Sure, you can brush your teeth twice a day and call it good — but your dentist won’t. When you brush your teeth, you can easily remove everything that’s stuck on the surface of your teeth, however, it’s unlikely you will remove anything that’s under the gumline or between the teeth. Toothbrushes can’t reach into these small spaces. Without flossing or using an alternative method like an interdental brush or Waterpik, the leftover debris and bacteria can inflame the gums. This can eventually lead to gum disease or tooth decay. Therefore, flossing is just as important as brushing!

Although there are several studies out there that disprove flossing as being necessary to prevent cavities and gum disease, if you take one moment to see all the gunk you pull out when you floss, you will easily see why it’s important. That gunk is a combination of plaque and bacteria. It can lead to cavities, gum disease, and bad breath if you don’t effectively clean between your teeth.

What’s the Best Way to Clean Between Teeth?

Given the fact that no one strategy works significantly better than the others, how do you decide which strategy to use? We recommend a three-part test. What will you use? What can you do? Lastly, what is effective?

If You Don’t Use It, It Can’t Help

The biggest priority is choosing a cleaning strategy that you’ll actually use. If you find flossing a chore and won’t do it, then it won’t do any good. You’re better off switching to interdental brushes or a Waterpik.

One study concluded that a Waterpik flosser and manual toothbrush were more effective at removing plaque than a manual toothbrush and string floss.

A study from 2019 found that interdental brushes provided similar effects to flossing but are more favorable to patients in regards to comfort and acceptance.

If You Can’t Use It, Why Try?

Some interdental cleaning methods are challenging. Flossing, for example, requires a significant amount of manual dexterity. If you don’t have that dexterity, then perhaps flossing isn’t right for you. Try using a flosser with the handle, interdental brushes, or a Waterpik. Ultimately, whatever is easiest for you to use, is the one that will provide the best results. Consistent use is the key.

If It’s Not Working, Try Something Else

Of course, you also want to make sure that your cleaning method is actually effective. There’s no point in doing nightly cleaning if it’s not making a difference. At your regular checkups, we will evaluate your oral health. This includes plaque, tartar, cavities, and gum disease. If we think you are at risk, we may recommend a change in your cleaning method. Although we always recommend flossing, interdental brushes and Waterpiks can provide similar results. Switching to an electric toothbrush from a manual toothbrush can also help remove more plaque and bacteria from between your teeth.

Work Together With Our Spokane Dentists

Ensuring oral health takes a team effort. Your daily hygiene routine is the most important part. We want to make sure you are doing all you can to protect your oral and overall health. Finding the right oral hygiene routine for you is even more important if you have dental implants or have just received  cosmetic dentistry treatments. The better you take care of your oral health, the longer-lasting your results. 

Please call (509) 532-1111 today to schedule your next appointment with our Spokane dentists at Collins Family & Cosmetic Dentistry in Spokane.