Between the Teeth

Monday April 12, 2021

It’s one of those things like Kleenex® or Ziploc®… know…when you think of a tissue or a resealable bag you think of these. The same goes for Waterpik®. There are different oral irrigators on the market. There are the ones made by Waterpik® and many others; even ones that attach to your sink or showerhead. 

I had never really recommended oral irrigators to my patients. The clinical research that I have seen never showed that these things were any more effective than flossing and brushing. I recently noticed that the packaging on the Waterpik® brand said that oral irrigation was 3X more effective than floss. So, I went back to the literature. 

The claims made by Waterpik® are from “independent” studies. This basically means that their own research shows they are more effective. While flossing is good, if you don’t use floss, any other aids used to clean teeth are better than none at all. Although, having experienced the Waterpik firsthand, I do feel there is more benefit than just for those with braces. 

Stimulation of the gum tissue is essential to a healthy mouth. It is also essential to remove bacteria both above and below the gumline. Oral irrigators do a great job of this. Like anything else, it takes a little getting used to. I realized quickly that you can actually experience tickling and pain at the same time with one of these things. It takes a little time to build up tolerance and be able to increase the pressure of the stream of water. Once you get used to it, it seems to be very effective in stimulating healthy tissue.

Oral irrigators are essential for both kids and adults with braces. They are also great for those with crowns, bridges, larger spaces between the teeth, people battling periodontal disease, or anyone trying to achieve healthier gums. The units come with an assortment of tips for different applications.

Waterpik® has both counter models and cordless hand-held models. The counter models have a wider range of pressure settings and a larger tank to hold water. The cordless models are very convenient for obvious reasons but the water compartment is very small. You typically have to fill the thing up about four times for each use. 

Here is the bottom line. If you brush and floss impeccably and your dentist or hygienist says your gum tissue is as healthy as it could be, a “water flosser” is probably overkill. In my experience, that is a very small portion of the population. Most people have room for improvement with their homecare.

The newest research I have seen, which was not done by a product manufacturer, shows that using a water flosser is significantly better than brushing alone. So, if you don’t floss, have braces, have any type of implants, any crowns, bridges, or veneers, have diabetes, or have been told you have gingivitis or any other type of periodontal disease, this product will most likely improve the report you get when you visit the dental office. 

Like anything, compliance is the key. Research shows that only 2-10% of the population flosses regularly and effectively and that the average brushing time is 37 seconds. Improvement comes with the effective use of the tools you have. You can get healthier and have good check-ups, but you have to put the time in.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at

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