Dental Hygiene Monthly: Tools for Plaque Removal

Dear Patients,

There are numerous ways to remove plaque from your teeth. Most people are aware of floss as the primary mode for plaque removal between the teeth. The thin string of waxed or unwaxed floss is great for many people. However, for some people floss just will not get the job done! For those patients there are other, more effective, ways of dealing with the plaque hiding between their teeth.

Floss is absolutely the ideal way to remove interproximal (area in between the teeth) plaque from a healthy mouth. The floss which is unwaxed is slightly more efficient at plaque removal. This is due to the fact that it is more abrasive, and thus removes more plaque. The proper way to floss is to pull the floss between the teeth and rub in an up and down motion against the side of the tooth. Many patients are confused about flossing properly. They will simply pop the floss between the teeth and pull it out. This style of flossing is not effective. In addition, wrapping the floss around the middle fingers and then directing between the teeth with the index fingers allows the most freedom for reaching the molars in the back of the mouth. Make sure to ask your hygienist to demonstrate this technique at your next appointment.

For patients who have more spacing between the teeth, either due to malalignment or periodontal (gum) disease a Proxabrush would be a better approach to interproximal cleaning. This brush is a small, often Christmas tree shaped, brush on a long handle. The brush is designed to push in and out between the teeth and to rub the sides of the teeth at the same time. When the gums are recessed and more space is present between the teeth the area needing to be cleaned is greater. The thicker brush on a Proxabrush is perfect for these more demanding areas.

Superfloss is another great device for plaque removal. This is best for patients in orthodontics or with bridges. This utensil has a floss threader at one end, spongy thick floss in the middle, with regular floss at the ends. The floss threader is a thin plastic which is flexible and allows access under orthodontic wires or dental bridges. Once access to these areas is achieved the thicker floss can be pulled through to clean under the bridge and between the teeth. The thin regular floss can also be pulled through to floss teeth behind wires. Orthodontia or bridges are no excuse for not flossing. These areas, like any other should be cleaned daily.

Oral irrigation is another implement in the fight against plaque. Periodontal disease causes the development of pockets between the teeth and gums. These deep pockets are almost impossible to clean. The use of an oral irrigator makes the area more accessible. Studies have shown that oral irrigating devices can reach up to 70% of the depth of the pocket. Irrigation is also helpful in reducing plaque that is between the teeth above the gum line. Irrigation can be used by orthodontic patients as well as those who just have poor manual dexterity. Irrigation uses either water or a mouthwash in a hand-held tip that is power driven. The liquid pulsates through the end of the tip and onto the surface of the tooth or into the pockets. The tips come in a variety of sizes which are interchangeable.

A recent find by our office is the Platypus flosser. This is one of the easiest ways for patients with braces to floss. Most hygienist will instruct people with braces to use the floss threader to floss their teeth. While this is a sure way to clean between all the teeth, it will also take quite awhile. Threading the device around the wires and between each tooth is incredibly time consuming. The Platypus actually allows access to the area that needs to be flossed with out using a threader. It has a thinly designed handle with floss on the end. The slim design reaches behind the arch wires, making flossing a breeze. It is disposable and small enough to carry with you while you are out. Considering the fact that I will be in braces in another couple of weeks, this is an especially exciting tool for me!

Ultimately, the fact is there are dozens of different devices out there to help patients clean between their teeth. Whether you have bridges, missing teeth, braces, or a full complement of 32 teeth something will certainly be of assistance to you. When you lack time or motivation to floss your teeth there are ways to get it done faster and without even looking in a mirror. Explore the different possible plaque removing apparatuses until you find one that suits you. Please do not hesitate to ask your hygienist if you want to explore things other than floss. We delight in helping our patients find a realistic home care and plaque removal routine.


Laura Dagostino, RDH

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