HomeHealth articlesdental flossWhich Is Best for Interdental Cleaning: Dental Floss vs. Water Flossers?

Dental Floss vs. Water Flossers for Interdental Cleaning: A Research-Based Perspective

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Dental floss and water flossers, also known as oral irrigators, are tools used for interdental cleaning. Read the article to know more.

Medically reviewed by

Dr. Lakshi Arora

Published At April 2, 2024
Reviewed AtApril 2, 2024


Dental research studies show that almost 30 percent of the total adult population globally use some form of interdental aid or the other as the oral hygiene adjunct apart from regular dental follow-ups to prevent the risk of gingival, periodontal diseases of the tooth, and dental caries. Interdental aids both, dental floss and water flossers (WFs) are effective in reducing these oral health problems.

How Does a Dental Floss Clean the Interdental Areas?

Amongst the many interdental methods, the most popular method is dental floss, which is widely preferred for dental care. As of today, very few research-based studies are available that may focus on which population groups use what kind of interdental aids. However, with regard to the frequency of the different interdental aids in trend today in the market, one can find multiple methods of cleaning out the interdental areas of the tooth. What exactly does an interdental aid do? For example, talking about the methodology or rationale behind the use of the common dental floss, which is a thin, flexible strand, designed to slide in between the teeth mainly serves to aid in the purpose of removal of all tooth-bound plaque and food particles. This is the reason why dental floss may remain the most successful method for interdental plaque removal even today.

One may get different types of floss in the commercial markets, ranging from waxed, unwaxed, and specialized floss. Registered dental care professionals or dentists would recommend which of these flossing methods would best suit the oral cavity and oral hygiene needs.

One can also expect to find a surprising number of variations within the common dental floss such as silk floss. Research studies show that irrespective of the floss types, nearly the same interdental cleaning efficacy would be achieved by these aids.

What Are the Types and Rationale of Water Flossers?

Coming to the next group of interdental aids that have taken over commercial dental markets, are the water flossers (WFs) and interdental brushing aids. Dental researchers as well as clinicians alike commonly recommend that apart from routine dental prophylaxis (dental cleaning) or scaling that needs to be performed every six months to once yearly by the dentist, using a combination of oral irrigation devices such as water flossers and interdental aids can prove to be one of the excellent benefactors for oral health. According to research studies, this group of devices meant for mechanical plaque control can not only significantly improve oral health, but can also avert the multiple complications of periodontal disease (diseases of the gums) upon systemic or multi-organ health, such as the impact on cardiovascular health and gastrointestinal health (as per preliminary medical research).

The classification of the types of water flossers that are available currently are:

  • Class 1 or Traditional Water Flossers: These are the standard WFs that possess a water reservoir and a nozzle. The rationale is to direct the water in between the interdental areas of the teeth and along the gumline effectively to clean out the plaque and food deposits.

  • Class 2 or Power-driven Water Flossers: This includes electric or power-driven flossers that incorporate extra settings or features like adjustability in pressure settings, directing the pulsating water streams for more enhanced cleaning in comparison to the traditional WFs.

  • Class 3 or Clinical Water Flossers: These are recommended by dental professionals and are used even in clinic post-procedures like dental scaling. These high-grade WFs are specifically for professional dental use, possessing extremely advanced features for precise control as well as for comprehensive interdental cleaning.

  • Class 4 or Portable Water Flossers: These are small, compact, easy to carry, or travel-friendly WFs that are powered by batteries or charging.

  • Class 5 or Adaptive WFs: These are highly advanced flossing models incorporating smart technology features customized to individual oral care needs and would be extremely useful for use in debilitated or immunocompromised patients.

What Are the Research Insights of Dental Floss vs Water Flossers?

Most dental professionals advise that the best combination to avert or control periodontal diseases is to combine water flossing with manual tooth brushing. Those individuals who not only did the manual tooth brushing twice a day, but also used water flossers or electric flossers tended to experience a significant clinical reduction in the parameters or markers for periodontal disease. For instance, water flossing and manual tooth brushing together can see a two-fold reduction in the bleeding on probing gingival index (a method used in dentistry to assess the severity of gingival inflammation), in comparison to individuals who use only a manual toothbrush along with traditional dental floss.

Similarly, research shows that when Individuals use water flossers after a powered toothbrush for brushing their teeth, a significant reduction was observed in the clinical symptoms of gingivitis (inflammation of the gingiva) in dental patients. Current dental research shows that water flossers (WFs) and manual tooth brushing can remove plaque just as efficiently as manual brushing with traditional tooth flossing using dental floss.

The research especially conducted on the lingual and facial surfaces of all teeth in dental patients, indicated that modern-day trends that incorporate the use of water flossers plus power tooth brushing were slightly more effective than manual brushing and flossing. A major Swedish international study group that assessed the usage of different interproximal cleaning aids in different age groups ranging from dental floss, interdental brushes (IDBs), and toothpicks daily, showed that every different age group used a different interdental aid or had their own preferred daily oral care routine. The results showed the statistics of dental floss being the clear winner in the younger age groups in comparison to other interdental aids and interdental brushes (IDBs) to be the popular choice for older adults or geriatric population groups. A major US-based research study further indicated that those lacking manual dexterity (the ability to use one's hands or manipulate objects with precision and skill), water flossers, and powered toothbrushes scored high in preventing and controlling periodontal disease.


Thus, in terms of both clinical penetrability into the interdental spaces of teeth and effectiveness, research studies show that WFs can be as effective or even a bit more efficacious in comparison to traditional or manual dental floss. The results are promising shortly with the advent of modern-day oral irrigation devices of different grades that can significantly reduce the risks caused by circulating periodontal pathogens in the oral cavity. The focus on dental products in the near future is to personalize or customize the oral devices to individual oral needs just like modern-day water flossers.

Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop



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