Toothbrushing Isn’t Enough

by | May 9, 2013 | Oral Health, Oral Hygiene

The statistics are all over the map, but one thing is clear: for most Americans, flossing isn’t a high priority. Most brush their teeth – if not as often or as well as they should – but less than half floss regularly. Some “forget.” Some make excuses.



Is it any surprise that half of us have periodontal (gum) disease, according to data from the CDC? This inflammatory condition has been linked with a number of systemic health problems, including diabetes, heart disease, stroke and rheumatoid arthritis.

It’s as simple as this: When you brush, you clean only about 60% of the surface area of your teeth – even if you use a fancy, sonic brush. It’s like bathing by washing from your feet up to the middle of your torso, leaving everything else increasingly filthy.

Flossing is what cleans the rest of your teeth – their necks, between them and at the gumline. As periodontal disease progresses, pockets form between your gums and teeth, becoming safe harbors for oral pathogens (bacteria, viruses and the like). The deeper the pockets, the harder to clean and the more gum disease advances.

And the more advanced your gum disease, the more likely you are to eventually wind up with a mouth like this:


Yes, gum disease also contributes to tooth loss. The disease ravages both the bone and soft tissues that support your teeth. As you lose this structure, your teeth begin to loosen. Eventually, they fall out (or your dentist recommends extracting them).

Knowing this, flossing suddenly doesn’t seem so bad, does it?

But there’s another option for cleaning the parts of your teeth that toothbrushes can’t manage: interproximal, or interdental, brushes. These fit between your teeth, where they can be manipulated along the necks and at the gumline. Many people find them easier and more comfortable to use than floss.

In fact, some research suggests they may be even better than floss! A research review in Evidence-Based Dentistry, for instance, found them more effective at removing biofilm. Pocket reduction also was much more “pronounced” among “proxy” brush users. A similar paper published early last year in the Canadian Journal of Dental Hygiene found these brushes to be “an effective alternative to dental floss for reducing interproximal bleeding and plaque.”

Here’s a quick demonstration of how they’re properly used:



You should be able to find proxy brushes at Walgreens or any other good sized drugstore. If all else fails, they’re readily available online from numerous retailers.

Whether you floss or use a proxy brush or even both (some do, especially if their gum disease is advanced), the main thing is this: Do it. Make it part of your routine for a healthy mouth (and a healthy rest-of-you, too).

Toothless mouth image via

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