Village Periodontics & Implant Dentistry


Flossing and Interdental Cleaning Alternatives

For years, periodontists, dentists and dental hygienists have tried to get patients to floss and then brush their teeth. Floss gets through the contact areas, the areas where teeth touch, side-by-side. These are the areas that brushes cannot reach and where decay and periodontitis (gum and bone loss) usually start. This is where we see bleeding upon probing, more often than on the flat cheek surfaces (buccal) or tongue (lingual) surfaces of the teeth.

For various reasons flossing is difficult for many people. Studies show that 83% don’t floss regularly. They just brush. Many people don’t brush well, either.

Recent studies have shown that other interdental cleaners are nearly as effective at cleaning in between teeth and some are superior to floss. The Aquarius model of Waterpik has been shown, in recent studies, to be very effective in cleaning these surfaces.

The best answer is that we should ask patients to do what they are comfortable doing when it comes to oral hygiene. If patients can floss and then brush, then that is the way to go. If they want to use interdental cleaners, including the Aquarious or the Sonicare Airfloss water system, and many manual picks and brushes to reach in between their teeth and then brush the other surfaces with regular toothbrushes, then that is the way to go.

The diagram shows proper flossing. It should be used in an up-and-down motion; not side-to-side and pulled just below the gum. Flossing, use of Waterpiks or other interdental cleaning aids should be done before normal brushing. This helps loosen plaque and debris that will be removed by traditional brushing.


Pictured are some examples of interdental cleaner alternatives to floss.

Proxabrush – many different brands






Different sizes of brushes from TePe, Butler GUM and even store brands, like Equate.

Waterpik (L) and Sonicare Airfloss

End-tufted brushes help in the lingual (tongue side) surfaces and harder to reach areas.









Abby Long