It’s perfectly okay to hate flossing. Go on. Hate it with all the hate you have for hateful things. Flossing: bad, boo, hiss!
But you still need to clean between your teeth – well, unless you’re a fan of tooth decay, gum disease, tooth loss, and lots (and lots) of dental work to repair the damage.
You’re in luck, though: Floss is hardly the only option. You can use interdental/proxy brushes. You can use floss picks, which many find much easier to handle than regular string floss, although they’re not quite as effective. You can use a Waterpik or other brand of oral irrigator/water flosser.
Of course, if you want to be an oral hygiene boss, you’ll incorporate multiple tools in your daily routine, to keep your mouth clean, your oral microbiome in balance, and your teeth and gums as healthy as they can be.
But if you had to choose just one, we’d say go for the oral irrigator. It’s Dr. Y’s go-to for controlling and preventing gum disease. This is because it does more than just clean the sides of your teeth and along the gumline. It flushes bacteria from the periodontal pockets around your teeth, as well.
These pockets form as harmful bacteria proliferate in the sulcus, which is the clinical term for the space where your teeth and gums meet. As the infection progresses, the pocket gets deeper – which, really, is just an invitation for more pathogens to join the party: Come on in! We have tons of room! It’s dark in here. And warm. And wet. And there’s not much oxygen. It’s a dream home!
Pockets deeper than 3 mm mean gum disease. The deeper the pocket, the more advanced and severe the disease. The more advanced and severe the disease, the more gum tissue and bone tissue you lose. Your gums may recede. Your teeth may loosen in their sockets and eventually come out completely.
Studies have shown that daily oral irrigation has the potential to suppress periodontal pathogens located within the pocket. Oral irrigation has demonstrated a reduction in proinflammatory mediators. Periodontal disease causing bacteria cause an increase in cytokine levels, which leads to bone resorption. Daily oral irrigation leads to a reduction in pro-inflammatory cytokines that leads to a slight, but significant, improvement in mild to moderate periodontal disease. In addition, oral irrigation has demonstrated a significant reduction in bleeding, gingivitis, periodontal pathogens and probing depths.
Using a phase contrast microscope we can readily see the difference that irrigation can make in terms of keeping harmful bacteria in check so helpful microbes can proliferate.
And that brings us to one of the latest studies on the effectiveness of oral irrigators.
All 60 patients who took part had been diagnosed with moderate periodontitis. Each underwent non-surgical periodontal treatment, with a followup one month later. Each was also taught a home care protocol that included using a sonic toothbrush, interdental brushes, and an oral irrigator.
At this point, phase contrast microscopy showed “the existence of non-pathogenic bacterial flora” in all patients, who were then randomly split into two groups. After getting a professional cleaning, one group was told to stop using the irrigator while the other was encouraged to keep up the whole home care protocol.
The next time samples of their oral bacteria were examined, 90% of the non-irrigator group showed a return of pathogenic bacteria. One hundred percent of the whole hygiene group “showed immobile plaque on phase contrast microscopic analysis.” In other words, their gums were healthy.
This research showed that oral irrigator in the practice of home hygiene protocols plays a role in the long-term maintenance of a non-pathogenic bacterial flora in periodontal patients.
Bottom line? Irrigators work.