You hear it all the time: brush and floss, brush and floss…though as we’ve noted before, there’s actually not a lot of good evidence supporting the flossing part.
That doesn’t mean you don’t need to bother cleaning between your teeth. You do – well, unless you’re happy with only cleaning the 60% or so of total tooth surface that a toothbrush can reach. And with having a higher risk of caries and gum disease, natch.
No, the question is simply this: What’s the best tool for the job?
Several years ago, a meta-analysis in Evidence Based Dentistry concluded that interproximal “proxy” brushes win out over both floss and perio-aids. And now a new review in the Journal of Clinical Periodontology lends some further weight.
The authors looked at 6 systematic reviews: two each on floss and proxy brushes, one on woodsticks (toothpicks) and one on oral irrigators (like Waterpiks).
Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs [interdental brushes] in combination with toothbrushing reduce both plaque and gingivitis.
In sum, while all methods showed some efficacy, there was more substantial evidence for proxy brushes.
Or you could put it another way: Any kind of interdental cleaning is better than none at all – provided it’s done correctly and safely – but for best results, opt for those proxy brushes.
Image by Hondrej, via Wikimedia Commons