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We all know that it is important to brush your teeth twice a day. However, it is equally important to be able to clean in between. Brushing the teeth only removes the plaque over the smooth surfaces of the teeth but cannot clean in between the teeth, where the teeth contact and under this area adjacent to the gums. A variety of tools are available to help with this and it is the purpose of this post to briefly describe these tools, which include:

• Dental floss
• Interdental brushes (interproximal brushes) e.g Tepe brushes
• Single tuft toothbrushes
• Interdental  picks or sticks
• Interdental rubber tip stimulators
• Pulsating water (or medicament ) spraying devices e.g the Waterpick

Dental floss

Dental Floss

Dental floss is effective at cleaning the areas of the teeth that contact, removing the plaque in these areas and also allowing air to get to these surfaces. It is important to get air to these surfaces as the bacteria that colonise these areas are ‘anaerobic’ and hence will reduce in number if exposed to oxygen. Dental floss is used by gaining 18 inches or so of floss, winding both ends around the middle fingers until about 2 inches length lie between the fingers.

Holding the floss

The floss is then gently passed between the contact points of the teeth and back again whilst maintaining contact with the side of the tooth. This is repeated with the adjacent tooth. The floss is then unwound slightly from one of the fingers so as to expose  a fresh piece of floss and the next contact point is then tackled.

Flossing technique

Dental floss comes as waxed and unwaxed and as floss or tape. Waxed floss usually glides between teeth best as does tape. The important thing is to find one that does not shred. For individuals who cannot hold dental floss, it is possible to get floss holding devices.

Dental floss holder

Interdental brushes

These are like little bottle brushes that fit in between teeth under their contact points. In this space where the gum may have receded leaving a void. The void varies in size and hence it is important to get the correct size of brush.

Interdental brush

These brushes can remove plaque in concavities in the sides of teeth and hence are better than floss at cleaning under the contact points of teeth. It is important to use a purely horizontal motion from the cheek side of the teeth and the tongue side of the teeth. If the brush gets stuck – do not push hard. It may be that the angle if insertion just needs modifying. After use, wash under water, ready for next use. After a while the bristles will  wear and a new brush should then be used. If the brush begins to move more easily between the teeth it may be a sign that the gum inflammation is reducing, thus leaving a relatively wider void between the teeth.

Interproximal brush technique

Single tuft toothbrushes

These are not as effective as interdental brushes at getting under the contact point, but are good at cleaning between teeth with crowns or bridges or where it is too difficult to get interproximal brushes due to access problems or the brush buckling.

Single tufted brush

Interdental sticks

These wooden stick are ideal for removing food particles (rather than plaque) from between teeth. In fact, they can actual wedge plaque up between the teeth rather than clearing it away. Again, they can be used where individuals find it hard using floss or interdental brushes, but must be used with some caution. There must be enough space under the tooth contact point to fit these sticks in (the flat end faces the gum). The sticks act as a gum massager but should not be used if gum bleeding occurs. They are not suitable for children.

Interdental wood sticks

Interdental rubber tip stimulators

Again, these can be useful in cleaning between teeth but are additionally used to massage the gums. They are not as effective as interdental brushes.

Interdental rubber tip stimulator

Pulsating water (or medicament ) spraying devices

These products force a steady stream of pulsating water between the teeth thus irrigating plaque away from under contact points. They are not a substitute for brushing but a useful adjunct to flossing and using interdental brushes.

Pulsating water spraying device - Waterpik

How do you clean in between your teeth? Discuss your needs with our hygienist the next time you see her.

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Tags: floss, interdental brushes, interdental cleaning, Oral hygiene, Tepe brushes.

This entry was posted on Sunday, January 2nd, 2011 at 11:51 pm and is filed under Oral hygiene. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.