Interdental cleaning is for everyone, so why isn’t everyone doing it?

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  Posted by: Dental Design      10th January 2024

All dental practitioners will advocate for interdental cleaning within a daily dental health routine; it’s the key to maintaining exceptional oral hygiene and avoiding disease. Every patient can learn how to do it, and find the right tool to use. They can safely clean between if they have a dental implant, wear an orthodontic appliance or have had crown or bridgework. Interdental cleaning can be performed by those already having therapy for periodontal problems and will support treatment success. Even people who are fully dentate can significantly elevate their health and wellbeing by using an interdental adjunct on a regular basis. Patients can choose what type of tool suits them best and, as a daily preventive practise, it requires very little effort or expense.

The benefits are numerous and ongoing and yet dentists and dental care professionals (DCPs) are still having conversations with people who admit to never cleaning between, or who have tried to get into the habit and failed. Interdental cleaning is so fundamental to oral health that there is no good reason not to do it. Therefore, support for patients who aren’t, is crucial.

The lack of quality information about various aspects of oral health, its link with general health and how to prevent problems and disease continues to be an issue. In 2022, a report revealed how only 15% of the UK population can recall being exposed to public health messages about mouth cancer, for example.[1] Despite the prevalence of periodontal disease, there is anecdotal evidence of how many patients do not understand its seriousness, how it differs from other gingival conditions and the fact that it can irreversibly destroy bone or lead to tooth loss.[2]

A dental professional’s role as an educator has therefore never been more important. People are overwhelmed by information that can be contradictory and unsourced, and so they don’t know where to start. They will appreciate the clear and unambiguous advice you give them, about how to improve and maintain dental hygiene.

A twice-daily brush, even when done correctly, is insufficient for optimising plaque removal. But ask patients what they know about interdental cleaning and you may find the number-one misconception is that, at best, it’s uncomfortable and, often, it’s painful. Yet with the right tool it’s neither and once they’ve got the technique, it’s easy to do.

Maybe patients have had a previous bad experience with dental floss, which is notoriously tricky and fiddly to use. Most patients do know, however, there are alternatives to floss, with interdental brushes (IDBs) available to buy from their practice, or on the high street. The two main messages about interdental brushing that you need to communicate are that, first, the clinical consensus for its effectiveness is well-documented, with research finding interdental brushing superior to flossing, for plaque removal.[3] Second, that size is everything! Interdental spaces are different in every mouth and the tools used to clean them comfortably and efficiently should not be one-size-fits-all either. There will be the perfect brush for each patient and you can help them work through a selection of sizes, until you find the right one.

Once they have it, show them how to manipulate it between their teeth, with one simple in-and-out movement, to physically disrupt
the structure of hidden biofilm, in a way that other adjuncts cannot. They may see debris on the brush; they will certainly feel how clean and fresh their mouth is afterwards. What they will also notice is how, unlike dental floss, the bristles of IDBs really get into deep corners and spaces without discomfort. With some ranges, the brush can be rinsed and reused, too, making them a great choice for anyone who wants to reduce their single-use plastic waste. CPS Prime IDBs, by leading Swiss oral health brand Curaprox, for example, not only come in a range of sizes, colour-coded for convenience, but the brush itself is made of bristles which are long and resilient and will last a long time. When the brush head does need replacing, the patient can just place a new one into the reusable angulated holder and click it into place. To help with education, professionals will also get a chairside box with samples, also tools to measure spaces and record and share this information.

We know that people can’t always get to see a dentist when they want, or where they want. Worries about being able to afford treatment is also keeping some of them away. Giving people simple but effective ways to maintain oral hygiene and avoid problems means a lower risk of disease, and fewer dental visits overall. Interdental cleaning, when it’s done properly, is one of the best lines of defence against disease, and should be taught at every consultation. Patients should not worry about discomfort, or it being a difficult technique to learn. With the highest quality tools the opposite is true, making interdental cleaning every dental professional’s not-so secret weapon for improving levels of oral health.

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[1] The State of Mouth Cancer Report 2022. Oral Health Foundation. Link: (accessed September 2023).

[2] Ahmed, H. Oral health: What is gum disease?. Br Dent J 222, 323 (2017).

[3] 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.

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