Cleaning Between Your Teeth

Tools That Honor Your Needs

Brushing your teeth twice a day is considered essential for maintaining oral health, but there’s one crucial area that brushing alone can’t reach: the spaces between your teeth. This is where plaque, food particles, and bacteria can accumulate, leading to cavities, gum issues, and bad breath. Interdental cleaning, whether through flossing, water flossers, soft picks, proxy brushes, or interdental brushes, is an essential practice for maintaining optimal oral health.

In this post, we’ll explore why cleaning between your teeth is so important, the tools available for the job, and how to choose the best method based on your unique oral health needs.

Why Brushing Alone Isn’t Enough

Brushing is important, but it misses a significant part of your mouth: the tight spaces between your teeth. Studies show that brushing alone removes only about 60% of plaque, leaving the rest trapped between your teeth and gums. This is why the American Dental Association (ADA) recommends adding an interdental cleaning tool to your routine.

Regular use of interdental cleaning tools—such as floss, water flossers, soft picks, proxy brushes, or interdental brushes—helps keep your gums healthy and reduces your risk of cavities. It's especially important for preventing gum issues, as plaque and food debris left between your teeth can contribute to inflammation, cavities, and other oral health concerns.

A Timeline of Interdental Cleaning Tools: From Ancient Times to Modern-Day Practices

Ancient Civilizations (BCE)

Early humans used various methods to clean their teeth, including chewing on twigs and using frayed fibers to clean between teeth. Archaeological findings show that the ancient Egyptians, Greeks, and Romans used primitive tools like toothpicks, made from bone, ivory, or metal, to clean their teeth. These early methods were effective at maintaining dental hygiene, especially in a time when people had wider dental arches and fewer dental problems.

The natural diet and lifestyle of these civilizations, including chewing fibrous foods and practicing proper nasal breathing, played a key role in maintaining wider dental arches. These factors led to greater space between teeth, reducing the need for more intensive interdental cleaning. When people ate a nutrient-dense diet, with plenty of fibrous foods, there was less need for frequent flossing. The chewing process naturally helped clean between the teeth, and proper nasal breathing supported jaw development and tooth spacing.

Medieval Times (5th–15th Century)

During the medieval period, toothpicks made from various materials were commonly used by the wealthy. For the general population, tools such as twigs, feathers, or bones were often used to clean between teeth. Brushing methods varied but were mostly limited to simple powders and abrasives.

Early 1800s: The First Floss

The invention of dental floss is attributed to Levi Spear Parmly, a dentist who, in 1815, recommended using a silk thread to clean between the teeth. His book A Practical Guide to the Management of the Teeth (1841) promoted flossing as a means to maintain oral health. Floss was originally made of silk and was the first known method of cleaning between teeth that was widely advocated by dental professionals.

1890s: Mass Production of Floss

In 1898, Johnson & Johnson began producing the first commercially available dental floss, made from silk. This mass-produced floss was marketed as a solution to improve oral hygiene, and it soon became a household staple.

Mid-20th Century: The Rise of Flossing

By the 1940s and 1950s, dental floss had become a common part of daily dental care in the United States. During this time, oral hygiene campaigns began promoting flossing as an essential step in maintaining optimal oral health.

1970s: The "Squeaky-Clean" Flossing Mentality

In the 1970s, the "squeaky clean" mentality took hold, as flossing was marketed as the key to achieving the perfect, bacteria-free mouth. The idea was that removing all bacteria and plaque was essential for maintaining healthy teeth. One notable example is the Peanuts cartoon, which promoted flossing as a way to get a perfect, clean mouth. The message was clear: to be as popular as Lucy, you needed to follow the "squeaky clean" flossing method.

However, modern science has taught us that not all bacteria are bad. The mouth hosts a complex microbiome, and the key to healthy gums is maintaining a balanced ecosystem, not completely eradicating all bacteria. Today, we know that leaving some beneficial bacteria in place can actually protect your oral health.

Supporting the Microbiome: A Modern Approach to Flossing

Biofilm—the thin layer of bacteria that naturally forms on your teeth—is healthy until it isn’t. For most people, biofilm acts as a protective layer, housing healthy bacteria that guard against harmful microbes. But the line between a healthy biofilm and problematic overgrowth varies from person to person, depending on factors like diet, lifestyle, and systemic health. This means that the approach to interdental cleaning should be personalized, focusing on removing the overgrowth of harmful bacteria while preserving the healthy species that keep your gums protected.

The microbiome acts as a "bouncer" at the gumline, preventing certain species of bacteria from entering the bloodstream through the gum pocket lining. I prefer my "bouncer" to be vital and healthy, not immature or geriatric. The balance of bacteria at the gumline is essential for protecting the body from harmful invaders.

Flossing vs. Water Flossers vs. Soft Picks, Proxy Brushes, and Interdental Brushes: What’s Right for You?

There’s a lot of discussion about which tool is best for cleaning between your teeth: traditional floss, water flossers, soft picks, proxy brushes, and interdental brushes. Here’s a breakdown of the benefits of each:

*Traditional string floss is effective at physically scraping plaque from between teeth and can reach areas that other tools might miss. It’s simple, inexpensive, and works well for those with tightly spaced teeth. However, overuse and aggressive use can affect the microbiome, and chemicals used in the manufacturing of certain flosses can cause health issues or disrupt the microbiome.

*Water flossers use a stream of pulsating water to clean between teeth. They can be particularly useful for people with dental implants, braces, or gum disease. However, they can disrupt the oral microbiome if overused, especially for people who do not have significant plaque buildup or overgrowth. Overuse of antimicrobial solutions in water flossers can create an imbalance in the oral ecosystem, similar to using an antibiotic in the mouth.

*Soft picks, proxy brushes, and interdental brushes are excellent for gently cleaning between teeth, especially for those with slightly wider gaps. They’re a great choice for everyday cleaning and provide a comfortable, effective solution for gum care.

The Importance of Personalization

Oral care is not a one-size-fits-all approach. Finding what works best for you depends on your teeth spacing, gum health, and overall health. Some people might benefit from using soft picks daily, while others may need to floss or use interdental brushes. The goal is to personalize your approach based on your unique needs and lifestyle.

For example, I personally use a soft pick every day, dipping it into my REVITIN toothpaste before brushing. I do this to gently clean between my teeth while preserving my oral microbiome. I floss about once a week, which is much less often than one might expect from a hygienist, but it works for me. I monitor my gums for signs of overgrowth, bleeding, or odor and adjust my cleaning routine as needed. It’s all about finding a method that works for you, based on your unique needs and habits.

Don’t feel guilty if you haven’t picked up the habit of flossing or if you don’t do it "the way you’ve been told." The truth is that habits are individual in expression and need. Some people who floss multiple times a day still experience issues, while others who rarely floss maintain great oral health. It’s not about rigid adherence to flossing rules, but rather about how your entire body and system function to express healthy teeth and gums.

Conclusion: A Balanced Approach for Healthy Teeth

Interdental cleaning is an essential part of your oral hygiene routine, but the key to success is balance. By choosing the right tool for your needs and focusing on maintaining a healthy microbiome, you can support your gums and teeth in a way that’s aligned with your overall health. It’s important to remove overgrowth to allow your saliva to remineralize the tooth surface, but this can be done gently, without resorting to aggressive methods or unnecessary antimicrobials.

Remember, your oral health journey is uniquely yours. It’s not about rigid rules or perfect habits—it's about finding a routine that works for you and honors your body’s individual needs. Whether you’re just starting your journey or refining your approach, know that you are not alone. You have a community of like-minded individuals who understand the ups and downs of holistic health. Together, we support each other with care, compassion, and the commitment to nurturing both our health and our microbiomes.

Choose a method that feels right for you and make it a consistent part of your daily routine. To learn more about what floss to use, start by reading my first blog about the forever chemicals in floss, based on a study published in 2019 discussing the connection to health issues in women who used chemical-laced floss products. Let’s walk this path together, supporting each other to make empowered choices for lasting, natural oral health.

Let's take this journey together—one step at a time, guided by knowledge, intention, and what truly supports your health. If you're ready to personalize your approach and find what works best for you, I invite you to consult with me so we can create a plan that aligns with your unique needs and wellness goals.