What's More Effective: Traditional Floss or a WaterPik?
Flossing is a major part of maintaining good oral hygiene, and the American Dental Association recommends flossing at least once a day. So what is the most effective way to remove particles from your teeth before plaque forms – traditional dental floss or oral irrigators like a WaterPik? Dental floss allows you to mechanically remove particles between the teeth and around the gums, while a WaterPik is a device that aims a stream of water at your teeth to remove plaque and bacteria.
No randomized clinical trial has directly compared flossing to a WaterPik, nor has it be determined which is superior. According to Ryan S. Lee, DDS, MPH, MHA, a fellow of dental oncology and maxillofacial prosthetics at Memorial Sloan-Kettering Cancer Center, both brushing and traditional flossing are recommended for his patients. "WaterPik does not prevent cavities and is only recommended in specific situations," says Dr. Lee.
Flossing Reigns Supreme
According to the Academy of General Dentistry, dental floss does a more effective job removing plaque and preventing gum disease than oral irrigators. Standard dental floss is generally considered the most effective tool for cleaning between the teeth. "The mechanical removal of plaque and bacteria is by far, without question, the most effective means of dental hygiene," says Washington, Pa. dentist Barry Bartusiak, DMD.
Dr. Bartusiak points out that a tooth has five surfaces, all of which traditional floss will clear. "Most problems originate in between the teeth. Flossing is the best way to access that area," says Bartusiak.
New Haven cosmetic dentist N. Summer Lerch, DDS, will always teach her patients to floss before prescribing a WaterPik. "WaterPik will remove large particles, but it doesn't get out the thin plaque that can cause tooth decay or gum disease. Flossing, on the other hand, is an actual mechanical scraping that when applied properly, hugs the whole side of the tooth. You're not blasting the bacteria with water, you're physically removing it," says Dr. Lerch.
When You Should Use a WaterPik
Flossing can be troublesome for people who have sensitive gums or wear braces. On the other hand, WaterPik is gentle on the gums and less likely to cause bleeding. According to a study at the University of Nebraska, patients who added a water flosser to either manual or power tooth brushing reduced bleeding, gingivitis and plaque just as well as manual brushing and string flossing.
Sometimes, WaterPik can help clean hard-to-reach places where flossing is difficult, like the back areas of molars. "For some populations, dental water jet systems can effectively reduce plaque between teeth and reduce gingivitis," says Lee. These patients include elderly folks with arthritis who might find it difficult to use dental floss. Another group would be those with orthodontic braces for whom flossing is not very effective because of the metal wires. "For most people, WaterPik is an additional tool on top of daily brushing and flossing," says Lee.
Bartusiak points out that a WaterPik can do some great things in terms of people with existing dental work. "If you had periodontal surgery or gum recession, a WaterPik can begin to remove some of those items that are more difficult to reach. If you have bridgework or implants, flossing can be more difficult," says Bartusiak. A WaterPik is sometimes recommended for people who have active gum disease because it flushes out bacteria from deep pockets that form when gums pull away from the teeth.
If you choose a WaterPik, Lee recommends a system that allows the user to control the strength of the water stream that is released.
Why Not Try Both Flossing and a WaterPik?
Lerch points out that WaterPik and floss should not take the place of each other. "If you love WaterPik, great. Keep using it, but also use traditional floss," says Lerch. She also notes that WaterPik may feel better than using traditional floss, which encourages patients to use it more. "By using the WaterPik, the gum is being stimulated in a way that it's supposed to. So use the WaterPik, but also floss," says Lerch.
Bartusiak points out that whether it's WaterPik or floss, taking a step towards better oral hygiene is positive. "Around 98 percent of the population doesn't floss on a regular basis. Is a WaterPik better than nothing? Absolutely. Is it a superior substitute for flossing? It is not," says Bartusiak.
Lerch also notes that it's important to look at the long-term effects of your flossing method. "Ten years down the line, the person using the WaterPik alone will have gingivitis and may have some form of periodontitis. The person who flosses will not," says Lerch.