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An alternative means to clean in-between!

Did you know that nearly two in five Australians NEVER floss or clean in-between their teeth? That means that there is a lot of food, plaque and bacteria living in-between the teeth of 38% of Australians!

At Dentists at Pymble, we thought that figure was quite high.  But then we thought, hang on… what about the rest of the population?! 

This is just the number of people who NEVER clean in-between, let alone people who may do it just once a fortnight or once a month…

 

So, how can you clean in-between your teeth?

Well… yes, there is the obvious, dental flosswhich I am sure everyone is probably pretty familiar with.  

But when it comes to flossing, we find that a lot of our patients comment on how they find it difficult as it is fiddly.  And we know that for flossing to be effective, it requires a good technique.  

But what if we said there are other ways that you could be cleaning in-between your teeth?

That’s right… there is actually more than one way!  

There are interdental brushes, there are oral irrigators, as well as interdental sticks or tips.  Now, we could talk about them all – as they each have their advantages and disadvantages – but for now we are just going to focus on interdental brushes.

At Dentists at Pymble we LOVE interdental brushes!

We find that interdental brushes can make it easier to clean between the teeth, that they can make it a lot easier to reach to the back teeth and thankfully, they can be less fiddly than flossing.  

So, in this article we are going to talk about interdental brushes at length.  We will start with understanding what interdental brushes are, how to use them, we will look at how effective they are, why the gums may bleed when you use them and finally, whether you should be using them too.

So, let’s talk interdental brushes!



What are interdental brushes?

Interdental brushes are like a mini toothbrush to help clean in-between your teeth. 
We often say that they look like a tiny bottle brush!

They have a little handle, which holds a fine, thin wire. Attached to the wire are little bristles or filaments.  Often, they have a cap as well, which slides over the bristles to keep it clean. 

Interdental brushes come in a wide range of sizes and shapes. And to make life easy, they are often colour coded, so you can easily tell the sizes apart.  

Interdental brushes can sometimes also be called interproximal brushes.  Although often at our practice, we find that patients generally refer to them by their brand name, such as Piksters or TePe brushes.

 

How do interdental brushes work?

Interdental brushes work by helping to disrupt and remove food, plaque and bacteria from in-between the teeth, where the toothbrush can’t get.

As we all know that, cleaning in-between our teeth, is something that has long been recommended that we do. 

So, why do we need to clean in-between our teeth?  

Simply, because nearly half the surface area of our teeth is in-between our teeth.

So, by not cleaning in-between our teeth, we are not removing a large amount of the plaque and bacteria from within our mouths. This can increase our risk of dental diseases – from gum disease to tooth decay (holes). But it can cause halitosis, aka bad breath!

 

Are interdental brushes just for cleaning in-between your teeth?

No… interdental brushes are not just for cleaning in-between your teeth.  

Interdental brushes can be used to clean under and around dental bridges and around dental implants.  They are also so commonly recommended for use around orthodontic appliances, such as braces. 


How do you use interdental brushes?

Using interdental brushes to clean in-between your teeth is quite simple.  

Here are our instructions for using an interdental brush:

  1. Using the appropriate size brush, hold the interdental brush between your thumb and index finger.  
  2. Position the brush between the gaps of your teeth, close to the gums. 
  3. Using a light pressure, push the brush between the teeth, and gently move the brush in an in-and-out motion a few times.  
  4. Remove the brush, and wipe or rinse any debris from it, then move to the next teeth. 

 

We recommend that when you are using interdental brushes that you do it while you are standing in front of a mirror.  That way you can see what you are doing and ensure that you are in the right spot.  It also helps to ensure that you don’t miss any teeth too!

And if your oral health professional has recommended interdental brushes for other than cleaning in-between your teeth, such as around a dental bridge or orthodontics, ask them to demonstrate to you how to use them. 

 

What if I find it difficult to get the brush in-between the teeth?

If you are having trouble getting the brush in-between your teeth, or if you are having to force it, you may cause damage to the teeth and gums.  This can be a sign that the brush is too big for the space or that there is something not quite right in that area.  

An interdental brush should fit comfortably and snugly between the teeth. 
They should require only a slight pressure to get them in-between the teeth.

If you are having to force the brush, or if it feels uncomfortable, you should arrange an appointment with your oral health professional to have it checked.  They will also be able to recommend to you the right sized brushes for your teeth and show you how to use them correctly. 

Are interdental brushes effective?

They are!  But you don’t have to just take our word for it. 

Researchers have found that interdental brushes can play a vital role in preventing oral diseases. It has been found that they are as good, and even potential superior to floss, in reducing plaque and gingivitis.

PLUS… they can be easier to use, have a higher acceptance rate and are especially indicated for people who have wider gaps between their teeth.

 

How often should you clean in-between your teeth?

Cleaning in-between your teeth should be done at least once a day, according to the Australian Dental Association. 

If you are at a higher risk of dental disease though, then we often we may recommend more frequent interdental cleaning. 

 


What size interdental brush should you use?

Using the correct size of interdental brush is important.  As if the brush is too small, then it may not be effective. Yet, if it is too big, you may struggle to get in-between your teeth and may inadvertently damage or traumatize the teeth and gums. 

Once the brush is in-between your teeth it should feel comfortable and fit snugly.

Some people actually use a range of different sized interdental brushes for their mouth.  For example, they may use a larger sized brush for their back teeth and smaller brushes for their front teeth. 

You should speak to your oral health professional about which size of interdental brush is best for you.

We are always happy to help you find the correct sized brush and to demonstrate how to use them effectively. 


Where can you buy interdental brushes from?

Interdental brushes are often available for purchase at supermarkets and chemists. But they may not always have the brand that you commonly use. So, you may need to shop around. Or if you are using a different brand check to make sure it is the right size before you buy it. 

We also sell interdental brushes here, at our practice. So, if you would ever like to purchase some, just ask one of our friendly team who would be more than happy to help you. 

 


Can you reuse interdental brushes?

Yes… most brands of interdental brushes can be reused.

After you have used the brush, rinse it well under water to clean and to remove any debris – like you would your toothbrush.  Then let the brush dry, pop the cap on and store it somewhere safe for next time.

 

How many times can you reuse an interdental brush?

As to how many times can you reuse an interdental brush, well that really depends on how it is looking.  

If the bristles start to look worn or shabby, or if the wire starts to fatigue (bend or twist), we recommend you throw it out and replace it with a new one.   Often an interdental brush may only last for 1-2 weeks.

It is worth noting though that many companies and brands are now introducing eco-friendly or plastic-free interdental brushes.  So, if you do not like the idea of more plastic brushes ending up in landfill, then we suggest that you have a look for these!

 

Why do my gums bleed when I use interdental brushes?

When plaque and bacteria has not been removed effectively from around the teeth and gums it can cause gum disease.   

Gum disease is the inflammation of the gums.

When gum disease is present, it is not uncommon for the gums to bleed. After a few days of correct interdental cleaning and good toothbrushing the inflammation caused by gum disease should start to resolve and the bleeding should start to reduce as well. 

If after 1-2 weeks, the bleeding has not resolved, or if you have not recently had a dental check-up, then at Dentists at Pymble, we recommend that you make an appointment with your dentist or oral health professional.  They will be able to check the area.  And they will also be able to review you are correctly using the interdental brush and are using the correct size. 

As if gum disease is left untreated it can cause periodontal disease. 

If you haven’t heard of periodontal disease, it is an advanced form of gum disease.  It can sometimes be called periodontitis or jawbone disease.

Periodontal disease is a condition that causes permanent damage and bone loss from around your teeth and gums.

But periodontal disease does not just impact on the health of your mouth.  Research has found that it can impact on your health as well. As did you know your oral health and general health are closely related?

So, it is pretty serious. And at our practice, we think that it is a REALLY good reason to ensure that you are cleaning in-between your teeth!

 

Should you use interdental brushes before or after you brush?

It is like the age-old debate… should you floss before or after you brush your teeth?   And many people would say that there is no right or wrong… as long as you do both! 

However, we generally suggest cleaning in-between your teeth first.

Why?  

As it helps the toothpaste to get between your teeth and to remove any debris that may have been dislodged while you were cleaning in-between.  

But we also find if you do it the other way around and brush first, people can sometimes be then less inclined to clean in-between their teeth. Simply because they have already gotten that “fresh mouth feeling” from the toothpaste!

But we aren’t the only ones suggesting you clean in-between then brush your teeth… 

Research investigating the sequence of flossing and toothbrushing, found that flossing then brushing is preferable. Again, because it helps to remove dislodged plaque and bacteria. But it also helps to increase the concentration of fluoride between the teeth. 

 

Do you need to put toothpaste on interdental brush?

We don’t recommend using toothpaste on an interdental brush – unless it has been recommended to you specifically by your treating oral health professional. 

 

What brand of interdental brush is best?

There are now many brands of interdental brushes available.  But it is not so much about which brand is best, rather it is… which is best for you!

We find that while one person may prefer one brand, someone else may not.  So, it is entirely up to you as to which you use.

However, sometimes the more expensive brands can be of a higher quality and last longer.  This means you may not have to replace them as often.  

 

So, should you be using interdental brushes?

Interdental brushes can make the task of cleaning in-between the teeth easier.  And it could potentially be more effective than flossing, according to the research.  

So, if you don’t already use interdental brushes, or if you aren’t using anything to clean between your teeth, then talk to your oral health professional about whether they are right for you.  As your oral health professional will be able to give you specific, tailored advice to your needs and will be able to show you all of your options.  

But, if you are happy with using dental floss, or have been recommended another form of interdental cleaning tool, then that is fine… as long as you are getting something to clean in-between regularly!

So, that wraps up all we have to share about our thoughts and findings on interdental brushes.  And I guess the reason why we are so passionate about finding ways for you to effectively clean in-between your teeth is because…

We see the benefits everyday of it, whether it be interdental brushes or by flossing!

And yes, we understand that there may be other (or better) things that you would rather be doing.

BUT… practising good oral hygiene habits is essential for maintaining good oral health.

And remember that it isn’t just our mouth that benefits from these good oral habits, our bodies do too!  As like we mentioned already, our general health and our oral health at closely linked.

So, from all the Dentists at Pymble we would like to say thank you for reading this article! 
And if you have any questions or concerns, then remember we are always here to help. 
So, please call the practice on 02 9488 7555 to make an appointment with one of our friendly dentists.

 


References:

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  2. Ng E, Lim LP. An overview of the different interdental cleaning aids and their effectiveness. Dentistry Journal. 2019;7(2):pii:E56. doi: 10.3390/dj7020056.
  3. American Dental Association. 2019. Oral health topics: floss/interdental cleaners. URL: https://www.ada.org/en/member-center/oral-health-topics/floss. Accessed: 18 April 2020.
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  6. Worthington  HV, MacDonald  L, Poklepovic Pericic  T, Sambunjak  D, Johnson  TM, Imai  P, Clarkson  JE. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database of Systematic Reviews 2019;4. doi: 10.1002/14651858.CD012018.pub2.
  7. Esteves I. The effectiveness of interdental brushes. Registered Dental Hygienist Magazine. 16 January 2014. URL https://www.rdhmag.com/patient-care/prosthodontics/article/16404305/the-effectiveness-of-interdental-brushes. Accessed: 18 April 2020.
  8. Colgate. Selecting dental products. URL: https://www.colgate.com/en-us/oral-health/basics/selecting-dental-products/is-flossing-hard-interdental-brushes-may-be-the-answer-0413. Accessed: 18 April 2020. 
  9. Oral Health Foundation. Gum disease. URL: https://www.dentalhealth.org/gum-disease. Accessed: 18 April 2020.
  10. Fleming E, Nguyen D, Woods PD. Prevalence of daily flossing among adults by selected risk factors for periodontal disease – United States, 2009-2014. Journal of Periodontology. 2018;89(8):933-939.
  11. Nagpal R, Yamashiro Y, Izumu Y. The two-way association of periodontal infection with systemic disorders: an overview. Mediators of Inflammation: Hindawi Publishing. 2015. doi: https://doi.org/10.1155/2015/793898. Accessed: 18 April 2020.
  12. Mazhari F, Boskabady M, Moeintaghavi A, Habibi A.  The effect of toothbrushing and flossing sequence on interdental plaque reduction and fluoride retention: a randomised controlled clinical trial. Journal of Periodontology. 2018;89(7):824-832.