Flossing is Overrated

Tuesday December 21, 2021

The two things you’re supposed to do to clean your teeth: Brush & Floss. Any of you have your hygienist get on your case about not flossing? You may be the best brusher in the world, but if you’re not cleaning between your teeth, we know it. Cleaning between the teeth is essential for good oral health, AND good overall health. 

To reiterate, we need to think about brushable surfaces vs. non-brushable surfaces in the mouth. Floss, which is basically a piece of string, is great after eating corn-on-the-cob. Other than that, using an oral irrigator (water flosser), is much better at cleaning the non-brushable areas in the mouth. 

Clinically, we usually see significant improvement in patients who add oral irrigation to their homecare routine. However, if you look at the research available, it is weak, just like that for flossing. There are just not a lot of studies that have been done. But anecdotally, I can tell you it is a game-changer for many.

The Waterpik® packaging says that oral irrigation is 3X more effective than floss. These claims are from “independent” studies; basically, their own research. While floss can be effective for some, many people get much better results with oral irrigation. Disease starts in the areas that you cannot brush. Brushing alone is not enough for anyone. A jet stream of water is great at disrupting the millions of bacteria living under your gumline. 

Stimulation of the gum tissue is essential to a healthy mouth. Oral irrigators do a great job of this. Like anything else, it takes a little getting used to. 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.

There are 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 it up about four times for each use. I prefer the counter-top models.

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 a tougher sell to add to the routine. In my experience, that is a very small portion of the population. Most people have room for improvement with their homecare.

The newest independent 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. The average brushing time is 37 seconds, as opposed to the recommended 2 minutes. Improvement comes with the effective use of the tools you have. An oral irrigator is a giant step to a healthier mouth!

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 snoring, 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 jpstclair@stclairdmd.com

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