With a choice of tools, help patients add interdental cleaning to their routine

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  Posted by: Dental Design      5th September 2022

Cleaning interdentally should be part of every good oral health routine, with a choice of tools to use, from simple floss to water irrigators.

But although interdental cleaning is a key message, statistics show that the majority of patients don’t. Even if you haven’t been looking at surveys and numbers, and being guided by the conversations you’re having, there is work to be done, to encourage more people to clean interdentally, daily.

Interdental cleaning, to loosen food debris and remove plaque bacteria before toothbrushing, means a cleaner, healthier mouth. Studies have found brushing alone is not “sufficiently effective” to improve gingival health, only removing “up to 60% of plaque at each episode of cleaning” on the facial surfaces of teeth compared to interproximal.[i] Interdental cleaning doesn’t take long to do, and the payoff is a reduced risk of caries, gingivitis and periodontal disease and fewer trips to the dentist for treatment. A simple way to improve health and wellbeing – so why isn’t everyone cleaning between?

We know that the routine use of dental floss is low.[ii] Anecdotally, many patients still find flossing difficult, uncomfortable and ‘fiddly’ and conflicting information online hasn’t helped poor acceptance either.[iii] Several years ago, there was a flurry of headlines stating that dental floss was no longer recommended by the American Dental Association (ADA) ­­– who, shortly after, released a statement defending the practise.[iv] Here in the UK, if patients search on the NHS website, they will find tips on how to floss.[v] If they find flossing difficult, the website says, they should ask their dental team for other ways they can clean between.

The grey areas that appear when the results of clinical studies are interpreted by the general press are a frustration for all healthcare professionals. Reviews of the literature around the routine use of dental floss do use phrasing such as “weak evidence”.[vi] But this does not mean that it has no benefits, or that a patient who enjoys flossing, who has no issues with using dental floss and has maintained a good standard of oral health due to their commitment to various practises and behaviours should stop. As well as the NHS, dental associations, groups and charities still advocate flossing, for those who want to, and can.

Just like ‘regular’ toothbrushing, technique is crucial and this is often the main reason for low compliance. It can be hard to get right – near impossible for anyone with limited dexterity – and if it’s not done properly, one thing that the research does agree on is that it doesn’t really add much to manual brushing.

One alternative that is becoming more popular, due to the increase of products on the market, is interdental brushing. For patients who don’t want to, or can’t floss, recommend they give one of these tools a try. Interdental brushes are not only for people with periodontal problems, they’re a preventive aid for those who are orally healthy – and want to stay that way.

Motivate patients by showing them how these tools come in different sizes, for comfort and efficacy. Supporting them with finding the right one for each space can promote better engagement and interest. An interdental brush should fit snugly in the space, to promote optimal removal and reduction of biofilm. A brush that is too small or too big will not do the job as well as one that is ‘snug’. If they don’t find floss easy to hold, there are interdental brushes that are designed to ensure a firm grip, while long filaments sweep debris away, for a satisfying super-clean sensation.

Patients might also appreciate that whereas dental floss often cannot be recycled, there are interdental brushes available with wooden handles that can be snapped off when it’s time to get a new one. Brands including the WOODI from TANDEX are a sustainable, eco-friendly option – the WOODI’s handle is made from FSC-certified birchwood and has also been manufactured using green energy sources. TANDEX also has a patient Educator Tool, which will give them information about which WOODI to use in each space, Passage Hole Diameter (PHD) and ISO numbers are displayed on the recyclable cardboard packaging and each of the six available sizes are uniquely colour-coded for easy selection.

Increasing motivation to clean between is tough, but with alternatives to floss available help patients find what works for them. Once they have the knack, and are using the right tool, they will find it will smoothly fit into their routine and make their mouth feel great. With access to dental services an ever-pressing problem, and people worrying about the cost of treatment, cleaning interdentally is an affordable, quick and easy way to elevate their oral health and reduce their risk of disease.  

For more information on Tandex’s range of products,
https://tandex.dk/ or visit the Facebook page

Our products are also available from CTS Dental Supplies and DHB Oral Healthcare


Author Kimberley Lloyd- Rees on behalf of Tandex

Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.


[i] Ng E, Lim LP. An Overview of Different Interdental Cleaning Aids and Their Effectiveness. Dent J (Basel). 2019 Jun 1;7(2):56. doi:10.3390/dj7020056. PMID: 31159354; PMCID: PMC6630384.

[ii] Dent J (Basel). 2019 Jun 1;7(2):56.

[iii] Dent J (Basel). 2019 Jun 1;7(2):56.

[iv] Should you floss or not? Study says benefits unproven. BBC, 3 August 2016. Link: https://www.bbc.co.uk/news/health-36962667 (accessed May 2022).

[v] Why should I use dental floss? NHS website, link: https://www.nhs.uk/common-health-questions/dental-health/why-should-i-use-dental-floss/ (accessed May 2022, page is due to be reviewed December 2022).

[vi] Dent J (Basel). 2019 Jun 1;7(2):56.

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