Today we are going to cover the F word no one wants to hear  …… FLOSS!! 

What were you thinking?

The last two weeks we covered toothbrushes and toothpaste. Now we need to get to the inbetween where you may be missing. 

Why is flossing important?

Brushing teeth correctly and consistently helps remove most dental plaque, bacteria and food debri. Regular, consistent flossing is yet another important tool to fight against plaque and gingivitis. 

Yet, in many cases, brushing alone can’t remove plaque and bacteria that is hiding in places where a toothbrush can’t reach. This includes in between the teeth and under the gums. 

In addition to removing plaque, flossing also helps to:

Remove food debris, plaque and bacteria that sticks between the teeth and under the gums

Control bad breath

Prevent or reverse gingivitis

Prevent or reverse cavities between the teeth (Also known as interproximal cavities.

Your child should floss at least once a day getting in between all of the teeth each time to be most effective to prevent interproximal cavities.

  • Floss, Water Flossers and Interdental Brushes
  • Flossing isn’t always a possible
  • Regular String Floss
  • Floss Picks
  • Water Flossers
  • Interdental brushes
Floss has long been recommended for cleaning between teeth as part of patients’ daily self-care routines since 1819 its origins in New Orleans, when Levi Spear Parmly, DDS, published the book, A Practical Guide to the Management of the Teeth.

The Big Question….Do I really need to floss?

Many people have argued that they brush regularly, they don’t floss, and never see food between their teeth.

Flossing isn’t necessary, seeing is always believing. Bacteria can be microscopic and invisible to the eye. Even if your teeth are not touching and have spaces, food particles can be trapped, creating a home in which plaque and tartar happily take residence.

And while it may not cause physical pain, it will seriously affect your teeth over time. In addition to that, what’s in your mouth is swallowed into your body. This bacteria has been the cause of serious health issues.

There has been a debate on whether it really works to reduce the cavities or other diseases.

However,  flossing is not the only way to get to those hard to reach areas and you do need to get those areas your toothbrush can’t.

Flossing has become the catch-all phrase for removing plaque and debris from between teeth. However, with such staggering low numbers of individuals who floss regularly, the use of the term “interproximal plaque removal” may be more relevant, as is the recommendation of interdental cleaning products that are not actually floss.

Evidence Base

Flossing and the use of other ways to get in between your teeth, like waterpik or interdental cleaners have been shown to disrupt and remove plaque, but there is not strong evidence to show they reduce the incidence of cavities or periodontal diseases. Plaque and bacteria also increase your risk of cardiovascular disease and Alzheimer’s. 

When reviewing the literature on the effectiveness of interproximal plaque removal devices, most studies were short in duration. This means that long-term efficacy is not demonstrated and the length of the studies was too brief for caries or periodontal diseases to develop. They don’t happen overnight. It takes alot to create dental disease that is why it is so preventable. 

Although strong evidence is not available, it does not mean that flossing and other interproximal devices are not effective. Many studies compare the effectiveness of interproximal devices with flossing.

Today, floss is available in a variety of types to meet patients’ individual needs, including unwaxed, waxed, woven, shred-resistant, bamboo, fluoride, and whitening. Made of Silk, Nylon, Polyester and teflon. 

Despite all these options, the use of floss by the American public remains low.

The ADA’s new recommendation is to brush teeth twice daily with a fluoride toothpaste and clean between teeth once a day.

This revised recommendation clearly emphasizes “clean between teeth” compared with “floss,” and states cleaning between teeth removes plaque that can lead to caries vs prevents caries. A paradigm shift is starting to occur in which the focus is moving from flossing to interproximal plaque removal. Plaque removal of any kind is better than nothing at all.

Types of dental floss

The different types of dental floss include the following:

String Floss

Floss picks

Water floss

Waxed and unwaxed

Woven and  Non woven

Flavored and unflavored

Wide and regular

Interdental brushes or picks

Flossing methods

There are a ton of different types of dental floss and the best dental floss for kids will be whatever is simplest and easiest  for you to work with. Or that you will actually use.

However, we generally recommend opting for a kids’ dental floss pick, or water flosser which can make things easier and use more consistently.. 

Methods of using floss:

String Floss:

Spool method (also called the finger-wrap method)

Cut off a piece of floss about18 to 20 inches long.

Lightly wrap each side of the piece of floss several times around each middle finger.

Next, carefully move the floss in between the teeth with your index fingers and thumbs cup the tooth forming a C shape and move the floss in an up and down, not side-to-side, motion.

Bring the floss up and down, making sure to go below the gum line. Bend it to stay along the side of each tooth. So you do not cut the gums, if this happens you may get bleeding. 

Loop method (also called the circle method)

Cut off a piece of floss that is about 18 inches long.

Tie it securely in a circle.

Next, place all of the fingers, except the thumb, within the loop.

Then use your index fingers to guide the floss through the lower teeth. Use your thumbs to guide the floss through the upper teeth. 

Go below the gum line, bending it to form a C on the side of each tooth.

 Pre-threaded flossers

If you’re using a kids’ dental floss pick, the floss will be pre-threaded and you’ll use the same technique of sliding it gently up and down one side of the tooth and under the gum line and then repeating on the other tooth. Whichever method you use, floss kids’ teeth once a day.

These may be helpful for people who are just learning how to floss. They may also help children with limited dexterity. They may be helpful and easier if you are flossing your child’s teeth.

Oral irrigators/ Water Flossers

Water may be an option if you just can not get the floss in your child’s mouth. These devices may help clean around braces where food sticks, or in areas a toothbrush can’t reach. Water flossers won’t remove plaque that contains harmful bacteria. You will need to use a toothbrush in combination with flossing.


Interdental cleaning products/devices—such as interdental brushes, wooden interdental cleaners, soft interdental cleaners, air and water flossers, and irrigation—are available to help individualize patient care for interproximal plaque removal. 

For patients who refuse or are unable to floss, interdental brushes and hard and soft interdental cleaners are effective, especially when there is a loss of interdental papilla. (pointy gum between the teeth.) and bigger spaces to clean.

Interdental brushes as an adjunct to toothbrushing are more effective in removing plaque compared with brushing alone or toothbrushing combined with flossing.

As interdental brushes are available in several shapes and sizes, it is important to recommend the appropriate fit for the interdental space to achieve maximum plaque removal. Tepe has all kinds of sizes.

Wooden, and soft plastic interdental cleaners can also be used to clean interdentally, as they meet the personal preferences of many consumers, are easy to carry, and are readily disposable.

The latest addition gaining popularity for interproximal plaque removal is powered interdental cleaners. Irrigation devices have been around for decades, yet they have recently been designed and targeted for interproximal cleaning due to research supporting the removal of interproximal plaque, in addition to reducing gingivitis. Water floss and air floss devices have been shown to be more ­effective in removing interproximal plaque and reducing gingivitis compared with the use of manual toothbrushing and string floss.

Flossing with regular string floss isn’t always possible. Some people have arthritis, don’t have the manual dexterity to floss or just don’t like to do it. 

That’s why there are other options available to get in between the teeth to get the surfaces your toothbrush cannot.

Floss Picks, Water Flossers and Interdental brushes are all great options if you are not a fan of flossing.  If you have implants or bridges, flossing will be important to protecting your investment.


Not everyone can use the original string floss and that is ok. Not everyone needs to floss. I know I create an up roar when I say this as a dental hygienist. It is true. The point of the floss is to get in between where the toothbrush can’t reach.  

If your teeth don’t touch and you have spaces between them you don’t need to floss. The toothbrush and water flosser will do the job. I cannot use floss picks on certain teeth. The floss breaks and gets stuck. I have a space that is so big I can fit the special tepe brush in that space.

You will still need to use something other than a toothbrush to get some areas depending on what is happening in your mouth specifically. 

Decide which floss option is best for you or the loved one. I have had many patients where I recommend a water flosser, saying they have one, they just never took it out of the box. 🙂  If you have one get it out try it. 


As an oral health coach, I highly recommend a good oral irrigator (even if you don’t use it daily) when it comes to home care. Manual and electric toothbrushes CAN do the same thing, whereas toothbrushes can’t do what irrigators do (flush out the inner lining of the gum pocket to help prevent them building a colony of plaque bacteria). They can also get further below the gum line than tooth brushes or floss.

If you cannot afford one at this time, maybe ask for one for the next special occasion Birthday, christmas, Mothers day, Fathers day

An oral irrigator, or water flosser, is a device that directs a forceful stream of water through a specialized tip and into the mouth.

The force of the water dislodges and washes away plaque, bits of food, and bacteria from the gums and teeth.

All water flossers have a reservoir to hold the water, and an electric motor to power the pump. The amount of water it holds depends on the brand and model. 

To clean areas a toothbrush misses or can’t reach, an oral irrigator is a great option. Also known as a “water flosser,” an oral irrigator can reach in between teeth. Unlike regular floss, irrigators come in a few different types and sizes, meaning you have some options to consider when searching for the best one.

The most important decision is the choice between portable irrigators that are handy for travel/space and countertop irrigators that offer more water and pressure control. In addition to the types, we’ll cover some important features and differences like the ideal reservoir size, adjustable pressure and flow controls, and different types of tips and nozzles you can use.

To help you find the best oral irrigator for your teeth, I have a few recommendations. You can check out different models, features, and considerations that will help keep your teeth clean and healthy.

How to use a oral irrigator hold the tip at a 90* angle toward the teeth holding for a few seconds in between to allow the water flow between the teeth and below the gumline to remove plaque or food debri.


You should start flossing as soon as any two teeth in your child’s mouth are touching. When the baby teeth first erupt, if they’re not anywhere near each other, brushing is the only thing you need to do. 

However, once the teeth touch, floss to get rid of cavities causing plaque in the area in between the teeth and under the gums, that your kiddo’s toothbrush can’t reach. Flossing also helps to get rid of food debris that can get stuck in the tight spaces of your little person’s smile and bonus it can help eliminate bad breath.

You probably won’t even need to think about flossing until around age 2 or 3. Many kids have spaces between the baby teeth to allow room for the permanent teeth, if this is the case for your child, flossing is not needed. 

Children often need help with both brushing and flossing until they are 8 to 10 years old. Depending on the child. So make sure you are available to supervise for the best results.


We all know we should brush our kids’ teeth, or have them brush their own teeth once they’re able to do a good job on their own, it is recommended we all brush twice a day. Morning and night. You know I feel that a toothbrush is the single most important tool you can use to fight against dental disease.  

But, flossing comes in a close second. I call it the F word because most people don’t want to hear it or cringe when you ask if they do it. So when do you start flossing your kids’ teeth? Or, the better question, how do you floss your kids’ teeth? It may seem like a daunting task especially if you are struggling just to get brushing done. 

Flossing can be a crucial part of your child’s oral hygiene routine. I am sharing my flossing knowledge to fill you in on when and how to floss your kids’ teeth, as well as some pointers for teaching them to do it on their own.

For Kiddos who don’t love when you floss their teeth and you need to do it for them. It may be helpful to try out different positions and opt for a method that is easier for you.  

 A floss pick may be better since you can maneuver them one-handed. You can sit behind your child and have them tilt their head back. Rest their head on your lap and use the hand that’s not holding the floss to gently pull back their cheek and lips so you can see what you’re doing. Or, if there’s another adult in the house, you can try the knee-to-knee technique, which you can see in action 

If you’re using traditional floss, grip a length of floss, about 18 inches, between your thumb and index finger and then wrap the floss around your index fingers. Gently guide the floss between any two teeth, relaxing it and curving it around a tooth in a C shape.

Floss up and down one side of that tooth sliding it under the gum line and then up and over the gum and down the side of the other tooth. Use a fresh section of floss between each set of teeth.


Most kids won’t have the dexterity to truly floss on their own until they’re about six years old or so and even then you’ll want to supervise until you’re confident in their abilities. However, it’s a good idea to teach kids to floss their teeth so they get the hang of it. Then, you can just follow up to make sure they didn’t miss any spots.Just like in toothbrushing.

 Here are some pointers for teaching kids to floss their teeth:

  • Demonstrate how to hold the floss and proper technique on yourself so they can learn what it looks like.
  • Let your kids watch you floss. Become a flossing role model and let your kids see you flossing your teeth every day. If you’re not a big flosser, now is the time to up your flossing game. 
  • Consider using kids’ dental floss picks. Fun colors and flavors can get them more excited about the process. Even with a floss pick, you’ll still need to demonstrate how to floss properly.
  • If you use regular string dental floss for kids, help them wrap the floss around their fingers, making sure it’s not so tight that it’s cutting off circulation.
  • Encourage kids to floss their teeth gently to avoid hurting their gums.
  • Keep practicing with kids until they’re using smooth, gentle motions and effectively cleaning their teeth.
  • If your child needs a bit of extra encouragement, a chart can be an awesome motivator. Every time they brush and floss, have them place a sticker on the chart. When they reach a predetermined amount of stickers, maybe they get to claim a prize. Or whatever works to motivate your child.

This is my opinion, if you feel you don’t have time and you are completely stressed about flossing. Skip the floss and take extra time to brush all the surfaces of the teeth with different toothbrushes.

 At night use a disclosing solution to see where areas are getting missed with the toothbrush. 

Now that you know how to floss your kids’ teeth, it’s time to get their pearly whites squeaky clean. If you have questions or you’re having trouble getting kids to floss, reach out or comment in the group. We will help answer questions and give you tips and tricks.


Flossing can no longer be identified as the primary method for interproximal plaque removal.  

Oral health practitioners need to critically analyze available data on interdental devices/products and provide individualized recommendations based on patient circumstances, preferences, and capabilities. 

In oral health, a paradigm shift is needed, moving away from use of the term “flossing” to “interproximal plaque removal.” 

Patients who are noncompliant or inadequate in their flossing habits finally have a variety of products from which to choose that meets their clinical circumstances, dexterity, and lifestyle. 

These effective alternatives may lead to improved compliance with interproximal plaque removal and, ultimately, improved oral health for patients.

Burst Floss  Promo Code 5ZMZBR or hearlthymouth


  1. American Dental Association. Federal Government, ADA Emphasize Importance of Flossing and Interdental Cleaners. Available at: Accessed November 18, 2018.
  2. Prichard D. A brief history of dental floss. Available at: Accessed November 18, 2018.
  3. United States Department of Health and Human Services. Dietary Guidelines for Americans. Available at: Accessed November 18, 2018.