The confusing world of interdental products - Dentistry IQ

The report states that increasing disposable income in developing countries including India, China, and Japan is leading to the market growth of interdental cleaning products. Many products such as dental floss, electric interdental toothbrushes, dental tapes, and tongue cleaners are being adopted by more people worldwide.1

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Dental professionals have had a big part in this growth, as they understand that sometimes brushing and flossing alone is not enough for some patients’ oral health. But getting patients to understand this can be another story. They tell you that they brush for two minutes, they floss every single day, and yet, when they visit the dentist, they’re told they have tooth decay, foul breath, gingivitis, or another malady. These all have a common thread: bacteria build-up that leads to biofilm 

So, now it’s up to dental hygienists and dentists to offer additional tools—interdental cleaning products—even though patients are truly doing a stellar job with both of those. In fact, many patients may have stood in the oral health-care aisle themselves and pondered an additional oral health tool, only to leave frustrated about the many choices and not knowing which one would be best for them.

Usual brushing techniques cover only the front of the teeth and conventional brushes cannot reach interdental spaces. These remain undisturbed and the perfect place for bacteria accumulation. So, even with great brushing habits, patients can still have dental plaque accumulation in interdental spaces. With the current advancements, thinner and smaller brushes have been devised that are instrumental in cleaning interdental spaces. These are deemed more effective than brushing as a monotherapy, and they’re swiftly replacing traditional dental floss.

Video: Interdental cleaning devices

Choosing the right interdental brushes

Interdental brushes are user-friendly and widely available. They’re a good topic of discussion because chances are, your patients have no idea what to choose and they look to you for guidance. Some key features to look for when choosing an interdental brush are the size of the brush, the softness of the bristles, its geometry (straight or angled), and reusability. 

Interdental brushes come in various sizes to suit different dental structures. They’re designed for people with braces and dental bridges and those with wider embrasures, while thin brushes are available for regular interdental cleaning. Metal wires in the middle of interdental brushes might be a little harsh for people with sensitive root surfaces. Rubber brushes are more recent developments emerging as viable alternatives to conventional brushes. These are as effective as metal brushes and offer greater compliance and acceptance among people in terms of comfort. And the goal, of course, is compliance.

It’s also important to choose an interdental brush based on its alignment to achieve better cleaning. Straight brushes provide access to hard-to-reach interdental cavities, while angled brushes facilitate precision and proper cleaning of frontal interdental spaces. For a deep-clean, waist-shaped brush heads are a good choice as they remove more biofilm than straight brushes, which results in minimal plaque deposit. Apart from this, conical and triangular brush heads are also recommended to clean molar cavities.

Because interdental brushes are small, the bristles are susceptible to wear and tear, resulting in sharp edges that might damage gums. On the earth-friendly side, many companies offer interdental brushes with detachable heads to minimize plastic waste, and this is more cost-effective for the consumer in the long run. 

Floss vs. tape: Different techniques, similar effects 

If there are patients who simply will not give up flossing, perhaps you can suggest dental tape. Tapes are not terribly different from floss. It’s broader and flatter, making interdental cleaning more convenient for people who have trouble handling thin strands of dental floss. Both tools effectively reach interdental spaces. However, a combination of brushing, flossing, and interdental brushing is recommended to keep plaque build-up low. 

Don’t forget to remind patients that flosses are available in waxed and unwaxed and come in a wide array of flavors. They need to be careful that the nylon material doesn’t shred or tear between teeth with high contact points. While single filament polytetrafluorethylene floss is more expensive than regular floss, it slides easily between teeth and is shred-resistant. When used properly, both options work well at removing debris and plaque. 

And don’t forget to discuss “electric flossers,” otherwise known as oral irrigators. These work well for people with braces, dental implants, and arthritis. 

Oral irrigators: The next game changers

Oral irrigators are electronic handheld flossing devices that eject water or air with water droplets to blast away debris, plaque build-up, and food particles from the interdental spaces. For people with periodontal disease, these are ideal for flushing out mucus and residue. Oral irrigators are ideal for people with sensitive gums, orthodontic appliances, diabetes, and dental implants.

In addition to the ability to remove bacterial cells and adherent plaque, oral irrigators effectively reduce inflammation in gums caused by crevicular fluid in diabetic and periodontic patients. By altering the host microbial interactions in subgingival spaces, water pulsations through oral irrigators effectively reduce inflammation without harming the soft gum tissue.

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Several companies such as Panasonic, Waterpik, Phillips, and ToiletTree are launching efficient, battery-powered oral irrigators for at-home use. When it comes to traditional oral irrigators, the Waterpik Aquarius Water Flosser is among the most popular. It has 10 different pressure settings developed to suit varying interdental spaces and gum sensitivity.

Another Waterpik product, Sonic-Fusion Professional flossing toothbrush, combines brushing and water flossing in one appliance. It has a built-in timer and provides adjustable water pressure controll options for sensitive teeth, stimulating blood flow in the gums to reduce swelling. Philips Sonicare AirFloss Ultra is a good fit for those looking for portable options. The compact design comprises a built-in water reservoir, long-lasting battery, and five nozzle sizes and pressure settings. 

There’s a reason the interdental market is increasing—patients are ready for a change. Start the conversation and offer your patients guidance and updates about the myriad of interdental products. Chances are they’ve stood in the oral care aisle and gotten overwhelmed. They want to have good oral health as much as you want them to.

Reference

Dental floss

When used properly, dental floss can be very effective at cleaning in between the teeth. The floss should be slid between the teeth, then held firmly against the side of the tooth with a gentle up and down movement to remove the plaque build-up on the tooth. It is important to hold the floss against the sides of each tooth as you clean them.

There are several different types of dental floss made in varying thickness as well as floss picks, which are pre-attached to a handle for convenience.

Because of mobility issues, hard to clean bridgework, tight spaces between teeth, or a variety of other reasons, traditional dental floss may not be the right fit for your oral health routine. There are plenty of alternatives that can be just as effective when done correctly.

Toothpicks

Standard toothpicks may work to dislodge food from our teeth, but they are not designed for dental cleaning. Since they are made from wood, toothpicks are usually sharp and brittle. They can easily sliver and lodge under the gums. The shape is not designed to fit between the teeth, so it can cause tissue damage.

Some toothpicks are designed with the proper shape to clean in between the teeth. The wood used is flexible when moistened and they are shaped to fit in between teeth without causing damage. Your dentist may have a sample you can try.

Interdental brush

There are several shapes and sizes of interdental brushes. Depending how your teeth are spaced, you may find these to be very useable. The interdental brush has several bristles attached to a thin bendable wire. The brush is gently inserted in between the teeth to clean the space. A thinner brush may be needed for your front teeth, while a wider brush may be needed for the back teeth.

These interdental brushes are also very good for cleaning underneath fixed bridge work. If you are having difficulty using these, or finding the correct shape for your teeth, your dentist or dental hygienist will be able to help. Usually each of these brushes lasts for about a week of use.

Dental water jets

Dental water jets or water flossers can be very effective for interdental cleaning. Water is pulsated under pressure and ejected through a small tip to clean in between teeth.

There are different designs and models of water jet devices. Choose carefully, studies have shown they are not all equally effective. Some have adjustable pressure settings and different designs or sizes on the tips. If you are unsure, it is recommended to look for the American Dental Association’s Seal of Acceptance.

This information in this post is for general educational purposes only and does not warrant or represent any information as related to health as specifically appropriate for you. It is not intended to be medical advice or replace the relationship that you have with your health care providers. You should always seek medical advice on any diagnosis or treatment from a qualified health care provider. The information is provided “as is” without any representations or warranties, express or implied.

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