Oral Hygiene Aids

Floss is one of the most effective ways of removing interdental plaque because of its ability to contour to the edges of the teeth and reach underneath the gum line. When considering which kind of floss to use, it's important to consider what kind of spaces you have in between your teeth. These spaces are called embrasures and they can be classified into 3 stages: Type I, II, and III. 

A- Type I

B- Type II

C- Type III

Waxed dental floss is best for those with close contacts between their teeth (i.e. those who have embrasures type I).1 The thinness and the waxy coating of floss allow the floss to squeeze in between close contact teeth easier and with less chance of breaking.2 The wax coating also increases the durability of the floss which is needed when used in between teeth. 

Advantages of waxed floss:

• Strength and durability

• Easy to insert between teeth

• Not traumatic to gum tissue

• Good for rough tooth surfaces and restorations

Disadvantages of waxed floss:

• Discomfort because of floss thickness1

• Difficult to use due to dexterity

Non-Waxed is a round floss that does not have a waxy coating. This floss type is suited for those with close contacts between the teeth (Type I embrasure) because of its thinness. This floss offered from waxed floss as it is slightly thinner, it also is less resistant to tears because it lacks the waxy coating.

Advantages: 

• Easy to slip in between teeth

Disadvantages:

• Can break easily when it rubs against calculus and restorations

Waxed and Non-waxed floss can be purchased at your local drugstore on the dental aisle or on Amazon. 

Yarn-like floss or woven dental floss is a thicker type of floss that is made from multiple strands of woven nylon or cotton.3 This type of floss is thicker than regular floss and can be beneficial for people with bigger gaps in between their teeth (Type II & III embrasure). 

Advantages: 

• Gentler on gums because of the material, thickness, and texture

• Easier to grip, reducing the potential of floss slipping in between fingers

• Effective at cleaning in between bigger gaps between teeth

• Texture provides a scrubbing mechanism in between teeth resulting in a cleaner feeling.

Disadvantages:

• May get stuck in between teeth because of thickness and fraying of floss

• Harder to find 4

To purchase woven floss, you may find options on online stores such as Amazon since in person availability at local stores may be limited.

Flavored floss can come in many flavors such as mint, cinnamon, coconut, bubblegum, etc. These floss types are great to use especially by children and adolescents to encourage building this healthy habit. 

Advantages:

• Appealing to use

• Motivates user to floss more regularly

• If its colored as well as flavored it can be easier to see while brushing improving flossing technique

Superfloss is a thicker type of floss that has 3 components: a stiff end threader, thick spongy floss, and regular floss.6  This kind of floss is suitable for patients who have greater spaces in between the teeth (type II & III embrasures), those who have orthodontic appliances, and fixed bridges. 

Advantages:

• Allows for flossing underneath appliances

• Flossing between wide gaps

• Reaches underneath the gums to remove plaque 

Superfloss can be purchased at your local drugstore on the dental aisle or on Amazon. 

Flossholder is an appliance that holds a small piece of floss around 1 inch long that is designed to be used all throughout the mouth. 

Advantages:

• May be easier to use for those who have lower dexterity and cannot intertwine floss around fingers like children, people with arthritis, and older adults

• Can help patients with sensitive gag reflex to reach posterior teeth

Disadvantages:

• Don't contain a clean segment of floss to use in between each dental space, resulting in bacteria being transferred from one interproximal space to other interproximal spaces

• Can be traumatic to the gums because of the snapping motion made whereas floss can be wiggled between the teeth to reach the gums

Flossholders can be purchased at your local drugstore on the dental aisle or on Amazon. 

Waterpiks are a type of water flossers that use vibrating/pulsating streams of water to remove plaque from between teeth. Waterpiks can be good options for those with low dexterity, people who have orthopedic appliances, crowns, bridges, and dental implants.7 

Advantages:

• Easy to use

• Reaches surfaces that are harder to reach

• Can clean between close contacting teeth

Disadvantages:

• May not remove all plaque in between teeth

• Expensive

• Can be messy to use7 

A power flosser uses “microburst technology” which is a combination of water droplets and air to clean in between teeth.8 Because of the similarities in technology, both waterpiks and power flossers have the same advantages and disadvantages (see section above for list)

See the following video for detailed instructions on how to use: How to Use a Waterpik™  Water Flosser

Waterpiks and Power Flossers can be purchased at retail stores such as Target, Walmart, Best Buy or can be purchased online.  

Tufted brushes is a type of brush that has a handle that contains a single head with bristles. 

This interdental aid is suitable for patients with:

• Wide gaps in between teeth (type II & III embrasures)

• Exposed root furcations

• Orthodontic appliances such as braces

• Prostheses

• Implants1

Advantages:

• Good for hard to reach areas

• Effective at cleaning spaces between teeth and roots (furcations)10

Tufted brushes can be purchased online at Walmart.com or on Amazon. 

End-tufted brushes are also known as single tuft brushes. They have one row of bristles on a head attached to a handle and occasionally are angled. 

These are best for:

• Wide gaps (Type III embrasures) 

• Reaching the back surfaces of the back teeth 

• Teeth near edentulous spaces (spaces where teeth are missing). 

• Crowded or misaligned teeth

• Use around orthodontic appliances1

Advantages:

• Good for hard to reach areas

• Good for brushing at the gum line of hard to reach teeth

• Effective at cleaning spaces between teeth and roots (furcations)10

See the following video for instructions on how to use tufted and end-tufted brushes: Interdental Cleaning -Single tufted toothbrush

End-tuft brushes can be purchased online at Walmart.com or on Amazon.

An interproximal brush is a handle that has a small brush tip attached which is either tapered or cylindrical1.

Interproximal brushes are best suited for patients with:

• Wide gaps in between teeth (Type II & III embrasure spaces)

• Exposed root furcations

• Root concavities

• Orthodontic appliances 

• Space maintainers

• Small diastemas 

• Fixed prostheses 

• Splints 

• Dental implants

Advantages:

• Reduce gum inflammation

• Reduce plaque

• Comfort

• Easy to use11

See the following video for instructions on how to use interproximal brushes

How to use an interdental brush effectively

Interproximal brushes can be purchased at your local drug store on the dental aisle or on Amazon. 

A sulcus brush is a type of end-tuft brush that is double-sided and designed to massage the gum line and prevent gingivitis. This interdental aid is most suited for those who have gingivitis, periodontal disease, bone loss, crowns, bridges, and implants.10 

Advantages:

• Removal of plaque in between teeth and under the gum line

• Stimulates gums to rejuvenate and prevent inflammation

• Reduce bleeding gums

• May slow the progression of periodontal disease10 

See the following video for instructions on how to use a sulcus brush: Sulcabrush Demonstration

Sulcus Brushes can be purchased online at Walmart.com or on Amazon.

Rubber tip stimulator Rubber tip stimulators are rubber tips connected to rods that are used to stimulate the gums. They are best suited for those who have gum disease to increase blood flow, increasing oxygen supplies at the affected site 

Advantages:

• Stimulation of gums helps prevent gum disease and stop active disease from worsening

• Can help clean plaque, and food from in between teeth

• Prevent tooth decay12

See the following video for instructions on how to use a rubber tip stimulator: How to use a rubber tip Gum Stimulator work - 3d animation video - Dental Solutions Clinic Bangalore

Rubber tip stimulators can be purchased at your local drug store on the dental aisle or on Amazon.

Wedge stimulator are similar to rubber tip stimulators in purpose. However they differ in material and shape as wedge stimulators are often made out of wood or plastic and are triangular in shape. 

Advantages: 

• Stimulate and massage gums which helps gum disease 

• Removes food debris and plaque caught in between teeth

• Useful in areas of bone loss

See the following video for instructions on how to use a wedge stimulator: How to Use a Stim-u-dent

Wedge stimulators can be purchased at your local drug store on the dental aisle or on Amazon.

Toothpicks are wooden sticks with pointed ends that are used to clean in between the teeth. Great care is needed when using toothpicks as many oral injuries can result such as splintering in the gums, trauma to the gums, blunting (flattening of the gums due to injury such as picking with a toothpick) of the interdental papilla (gums between the teeth), gum recession, and grooves on tooth and root surfaces caused by abrasion. Although toothpicks are widely accepted and easier to use, the risk posed to gum health outweigh the advantages and they are not recommended for use. 1

For more reasons on why toothpicks should not be used see the following video: This is what a toothpick can do to your teeth!

Tongue Scrapers are dental aids that are used to gently scrape the tongue to remove plaque build up. There are various types of tongue scrapers made from different materials such as metal, plastic, brushes, and single use. 

Advantages:

• Improve bad breath

• Decrease bacteria in the mouth and tongue

• Decrease risk of cavities

• Enhance taste13

See the following video for instructions on how to use a tongue scraper:

CURAPROX I TONGUE CLEANER I THE CORRECT USE I EN

Tongue scrapers can be purchased at your local drug store on the dental aisle or on Amazon.