Most people brush their teeth daily since they were old enough to do so. On the other hand, flossing is not being done daily, like brushing by most people, even though their dentists and hygienists have advocated daily flossing.

Scientific evidence has long established that brushing your teeth is crucial for fighting cavities and gum disease. Seventy percent of Americans brush their teeth twice a day for about 2 minutes each. However, twenty-three percent of Americans have gone two or more days without brushing their teeth. The rest brush once a day, either in the morning or in the evening.

Flossing daily only happens in about forty percent of the population, and twenty percent do not floss at all.

Is flossing as crucial in fighting cavities and gum disease as brushing as advocated by most dental professionals and dental associations?

To answer this question, first, we have to look at the purpose of flossing. The purpose of flossing is to remove plaque and biofilm on the teeth and food debris in between teeth using a piece of floss. In a nutshell, it is for interdental cleaning. The process requires intimate contact of the floss on the tooth surfaces. The spaces between teeth differ from one site to another and from one person to another. Some interdental spaces are significant and have concavities in the morphology of the roots. But we all know that there are other devices that can clean the areas in between teeth, namely the toothpick, proxabrush, end-tuff brush, interdental brush like Rotadent electric brush, and Waterpik. They all can help remove debris and interproximal dental plaque, the plaque that collects between two teeth.


The problem with flossing is that it is not easy to do, is technique sensitive, and requires good hand dexterity to achieve the intended results. It can be time-consuming and frustrating, especially if you are trying to floss the back teeth, the contacts are too tight, and having braces. If the flossing is not done right, you can hurt the gums and create an open wound for gum disease and infection. In my opinion, if the alternative device can effectively remove most, if not all, the plaque and debris in between teeth, and you are happy with it, then stick to it and not to worry about flossing.

A report by the Associated Press that looked at 25 scientific studies that generally compared the use of toothbrushes with the combination of toothbrush and floss fail to conclusively demonstrate that flossing is generally effective in plaque removal.
In light of this situation, we asked ourselves the following question:

Which alternatives to dental floss would both patients and science love?

There was a study done by the University of British Columbia on interdental plaque removal. Some interesting conclusions were

  1. “Patients rarely use dental floss.” – It is both time consuming, challenging, and frustrating to use dental floss. Sometimes, the floss shreds or breaks at certain contacts. In other situations, the floss catches the overhang of a filling. People who have large hands and or poor dexterity would have a tough time doing flossing.
  2. “Interdental brushes are easy to use and well accepted by patients.” – The study found that patients were more likely to use interdental brushes daily than flossing because of their ease.
  3. “Interdental brushes significantly reduce bleeding sites.”
    Interdental brushes are generally less likely to damage gums than flossing, and they are very effective in removing biofilm and food debris in the interproximal spaces. I usually recommend patient to use toothpaste on the brushes to help to improve the biofilm removal ability and the introduction of fluoride and other beneficial compounds directly in the spaces
  4. “Colorimetric probe and interdental brushing are more beneficial than interdental brushing alone.”
    An interdental brush system offers an interdental probe that determines the brush size that fills the interdental space. This is usually done chair-side during the examination and cleaning appointment. By finding out the right size of the interdental brush to be used, the biofilm in the interdental areas can be more effectively cleaned
  5. If you have tight contacts between teeth, nice arch forms, good bites, and your interproximal areas are filled with healthy strong gum tissue (interdental papillae), food and debris seldomly can get in underneath the gum tissues. Flossing is not needed daily unless there is a piece of food stuck in between (only for that site with food in it). Nonetheless, the interproximal spaces should be meticulously cleaned of food and biofilm. A manual pointy brush like proxabrush, a vibrating electric toothbrush like Sonicare, or a rotating electric toothbrush with a pointed end like Rotadent can be utilized to clean the interdental areas effectively.



    Good oral hygiene involves more than just brushing your teeth with a toothbrush. It also consists of cleaning the spaces between the teeth to remove plaque and biofilm. Flossing along may not be effective in removing all the unwanted stuff in between teeth in certain situations. Other interdental devices may be needed to achieve cleaner and healthy gums in between teeth.

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    If you would like to book an appointment or have questions about permanent teeth, please call Dr Wong at Affinity Dental Care by giving us a call at (289)-861-5111.


    03 Nov, 2022

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