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Floss Substitutes

November 6th, 2014

From the desk of Dr. Fass

OK, we know that everyone isn’t the most compliant when it comes to flossing every day but the simple truth is that the only way to prevent dental disease is to remove the bacterial plaque from all the surfaces of the teeth all the way down to the gum line. Tooth brushes work fine for the outside and inside, but can’t reach between the teeth. Floss works best since it flexes to contact all the surfaces as it is wrapped around the teeth. By gently moving up and down the teeth, plaque is removed well.
Unfortunately, not everyone can handle floss well. Some don’t have the dexterity, others may have a gag reflex, and others simply find it too difficult to do. There are some options that can provide a good level of prevention.
The best methods are mechanical removal tools. Stim-U-Dents® are small balsa wood toothpicks that are very soft and splay out to reach well between teeth. The soft wood won’t hurt the gums, won’t splinter, and doesn’t fall apart during use. They come in packs of anywhere from 6 to 300. Try a small pack first to see if they are right for you. Other varieties of toothpicks in plastic can work but they don’t soften or flare out and can damage the gums if used too vigorously. Floss Picks® have a plastic toothpick on one end and a short floss segment held by a plastic “fork” that allows one handed flossing. This works well but requires some practice for everyday use.
Interdental brushes come in a number of shapes and sizes. They are small brushes on handles that simply go between teeth to clean. The small cone shaped ones work the best and are available as Prox-a-brush® or Te Pe® brushes among other brands. These are fine if not forced into tight contacts where the bind up. If they don’t slide in with 2 finger pressure, they shouldn’t be used.

Rubber tip stimulators (Remember those Py-Co-Pay toothbrushes with the rupper tip on the handle?) can be useful, but they don’t reach very well between the wide molar teeth. Some come on their own handle and are harder plastic rather than the soft rubber we prefer.

Water Piks® and other “water flossing” devices are an OK adjunct after brushing and flossing, but they don’t remove the sticky surface layer under the plaque and therefore allow re-growth of bacteria faster. Sort of like taking your car to a brushless car wash. It looks clean until you wipe a finger across the surface and see that bottom layer of grime.
Finally, mouthwashes make many claims about plaque removal. The fact is, when you read the fine print, they all are recommended along with brushing and flossing, not as a stand alone product for oral care.

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