Floss, Interdental Brushes or a Water Flosser: Which Is Best for Your Gums?

Brushing twice a day is an essential part of looking after your teeth and gums, but your toothbrush cannot effectively reach every surface.

The spaces between your teeth are particularly important. Plaque can accumulate here relatively unnoticed, contributing to inflammation, bleeding and, in susceptible people, the development or progression of gum disease.

That is why cleaning between your teeth should form part of your daily routine. The NHS recommends cleaning between the teeth every day using floss or interdental brushes, alongside twice-daily brushing with fluoride toothpaste.

But with dental floss, interdental brushes and water flossers all widely available, which should you actually use?

The answer is not necessarily the same for everyone.

Why brushing alone is not enough

A toothbrush is designed to clean the visible surfaces of the teeth and around the gum line. However, the sides of neighbouring teeth create areas that toothbrush bristles may struggle to reach.

Plaque left between the teeth can irritate the gums and contribute to gingivitis, the earliest stage of gum disease. If inflammation persists in someone who is susceptible to periodontitis, the supporting tissues around the teeth can become affected.

The European Federation of Periodontology recommends daily interdental cleaning as part of good oral hygiene, alongside brushing at least twice a day. https://www.efp.org/for-patients/gum-diseases/gum-disease-prevention/

The important question is therefore not simply whether you clean between your teeth, but which method allows you to do it thoroughly, safely and consistently.

Are interdental brushes better than floss?

For many people, particularly those with spaces large enough to accommodate them, interdental brushes are often the preferred option.

These are very small brushes designed to pass gently between neighbouring teeth and physically disrupt plaque from surfaces that a conventional toothbrush cannot access.

Research has generally found interdental brushes to be particularly effective at reducing plaque and gum inflammation when used alongside toothbrushing. They can be especially useful for people with:

• spaces between their teeth
• a history of gum disease
• gum recession
• crowns, bridges or other dental work
• orthodontic appliances
• areas that are difficult to clean effectively with floss

Choosing the correct size is important. An interdental brush should make gentle contact with the sides of the teeth without needing to be forced through the space.

You may also need more than one size around your mouth. The spaces between teeth are rarely identical.

For patients receiving periodontal care, this is one reason professional oral hygiene instruction is so valuable. A periodontal team can identify which areas require particular attention and demonstrate the most appropriate technique for your individual mouth.

When is dental floss useful?

Floss still has an important role.

Where neighbouring teeth are very close together and an interdental brush cannot pass through safely, dental floss can reach areas that would otherwise remain uncleaned.

Rather than simply moving floss up and down through the contact point, the aim is to gently curve it around the side of each tooth and clean slightly beneath the gum margin.

Technique matters.

For some people, particularly where there are larger spaces or a history of periodontal disease, floss may not provide the same level of cleaning as an appropriately sized interdental brush. Evidence comparing different methods has generally favoured interdental brushes where there is sufficient space to use them.

However, that does not make floss ineffective or unnecessary. In a mouth with very tight contacts, it may be exactly the right tool.

In fact, many people benefit from using a combination of interdental brushes and floss in different parts of the mouth, rather than choosing one method exclusively.

What about water flossers?

Water flossers, sometimes called oral irrigators, use a directed stream of water to clean around and between the teeth and along the gum line.

They have become increasingly popular, particularly among people who find traditional floss difficult to use.

Research suggests that water flossers can help reduce gingival inflammation and bleeding when used as an addition to toothbrushing. Some studies have found encouraging results compared with other methods of interdental cleaning, although the overall evidence varies depending on the patient group and outcome being measured.

They may be particularly useful for people who:

• struggle with manual dexterity
• find flossing difficult to maintain
• have orthodontic appliances
• have extensive restorative dental work
• want an additional way of cleaning around difficult areas

A water flosser should not automatically be viewed as a replacement for every other form of interdental cleaning, however.

The most appropriate approach depends on your gum health, the size and shape of the spaces between your teeth and how effectively you are able to use each device.

So, which is best?

For many patients, the hierarchy is relatively straightforward:

If an interdental brush fits comfortably, it will often be the first choice.

If the space is too tight for a brush, floss may be more appropriate.

A water flosser can be a useful additional or alternative tool for certain patients, particularly where conventional interdental cleaning is difficult.

But the best method is ultimately the one that is appropriate for your mouth, used correctly and consistently.

This is particularly important if you already have periodontal disease. The spaces around the teeth can change as inflammation reduces or following treatment, meaning the cleaning tools and sizes that suit you today may need to be reviewed over time.

What if your gums bleed when you clean between your teeth?

Seeing blood when you first begin interdental cleaning can understandably make you want to stop.

However, bleeding gums are commonly associated with inflammation caused by plaque accumulation. The NHS advises seeing a dentist if your gums bleed when brushing or cleaning between the teeth. https://www.nhs.uk/conditions/gum-disease/

Rather than abandoning interdental cleaning altogether, it is worth having the area assessed and checking that your technique is correct.

Persistent bleeding, swelling, recession, bad breath, loose teeth or changes in the spaces between your teeth deserve professional attention. These can all be associated with periodontal problems and are better investigated early.

If you are concerned about changes in your gum health, an RW Perio Specialist Assessment provides a detailed evaluation of the gums and supporting tissues, allowing an appropriate treatment and home-care plan to be developed.

Cleaning well is only part of maintaining healthy gums

The aim of interdental cleaning is not to achieve a temporarily cleaner feeling. It is to control plaque consistently enough to support healthy tissues over the long term.

For someone who has previously undergone periodontal treatment, that daily home care works alongside professional monitoring.

The RW Perio Maintenance pathway is designed to help maintain periodontal stability following treatment, with ongoing assessment and professional care tailored to the individual patient.

Your interdental routine may also evolve. Changes in gum health, dental treatment, orthodontics or simply ageing can alter which areas are easiest or most difficult to clean.

There is no single perfect product

It is easy to turn oral care into a debate about which device is “best”.

In reality, there is no universal winner.

Interdental brushes have particularly strong evidence where they can be used effectively. Floss remains valuable for tight spaces. Water flossers can provide an effective and practical option for selected patients.

What matters most is that the spaces between your teeth are being cleaned every day with a method suited to your individual gum health.

If you are unsure, bring your floss, brushes or water flosser with you to your next dental or periodontal appointment. A small adjustment in size or technique can make a significant difference to how effectively you are cleaning.

Healthy gums are supported by the habits repeated every day, not simply what happens in the dental chair.