Dentists know you hate flossing. Try this instead.

Bangkok Post

5 days ago

Lancette VanGuilder is the president of the American Dental Hygienists' Association, and she does not floss.
'We are brainwashed from the time we get into dental hygiene school that floss is boss,' said VanGuilder, who practices in Nevada. 'But the standard message we give everyone — brush and floss — doesn't work anymore.'
To better clean between her teeth, VanGuilder has replaced her floss with tiny scrubbers called interdental brushes, with bristles that are typically made of nylon or rubber. And a growing number of dental professionals are encouraging their patients to try them, either along with or instead of floss.
The American Dental Association says that the best method of interdental cleaning, or cleaning between your teeth, is the one that you will do regularly. And given that many people do not floss — only about one-third of Americans do, according to some estimates — the association advises dentists that other devices might be more pleasant or effective for those patients. According to the association, there are many effective tools for cleaning between teeth, including floss, dental picks, interdental brushes or water flossers.
There is limited research comparing floss with other interdental cleaning tools, and most of those studies are relatively small. But a 2018 review of 22 clinical trials found that the brushes were more effective than floss or other tools at reducing gum inflammation.
Anecdotally, many dental professionals said they had seen the difference interdental brushes have made for their patients — and sometimes even for their families.
Dr Mia Geisinger, president of the American Academy of Periodontology, convinced her husband to add interdental brushes to his daily brushing and flossing regimen.
'When he saw what came out from between his teeth, he was both appalled and hooked,' she said.
A deeper clean for your mouth
Whatever the tool or technique, the goal of cleaning your teeth is to get rid of plaque, which can lead to gum disease and inflammation around the tooth, according to the US Centers for Disease Control and Prevention. Gum disease has been associated with a number of health conditions, including heart disease and diabetes.
Using a toothbrush alone removes 'about 40 to 60% of the plaque on teeth but doesn't do a good job of getting in between the teeth,' Geisinger said.
VanGuilder added that floss is generally effective for getting out big pieces of food, but when it comes to plaque — 'all the invisible bacteria, viruses, fungi and parasites' — it doesn't always work as well.
The challenge is twofold: Plaque is sticky, and the edges of your teeth aren't straight. Everyone's mouth is different, and some people are better than others at flossing in the nooks and crannies where pathogens live.
Interdental brushes, on the other hand, are more flexible and they're easier to use correctly, VanGuilder said.
How to find what works for you
For those willing to put in the time, a combination of tools might be most effective. That's why when those patients come to visit Geisinger, she hands them a map of their mouths. She generally recommends interdental brushes of various sizes to clean between teeth, and suggests floss if a patient has a very tight space between two teeth.
But Judith Albino, president emerita of the University of Colorado and professor emerita at the university's schools of public health and dental medicine, is sceptical that many people will take up a complicated dental routine.
Most Americans don't follow the standard dental advice, she said. 'If you're adding something new, you're adding another element of time, and something to do that they're not used to,' Albino said.
For that reason, VanGuilder leaves the decision up to her patients. If they prefer floss, she tells them to floss. If they prefer an interdental brush, she'll tell them which size to buy. If they're particularly enthusiastic, she'll guide them through using various brushes for spaces of different sizes.
'Ultimately, the only tool that's really beneficial is the tool that you're going to use,' VanGuilder said.