Flossing: The Right Technique (and Alternatives That Work)

Why flossing matters

Brushing reaches the facial and lingual tooth surfaces. Floss — or a properly sized interdental brush — is the only thing that reaches between teeth where 40% of plaque accumulates. Skipping this leaves half your job undone.

The correct technique

1. 18 inches of floss — enough to use a clean segment between each tooth pair
2. Wrap around middle fingers, pinch with thumbs and index fingers
3. Slide gently between teeth with sawing motion (not snapped in)
4. Wrap around one tooth in a C-shape and slide up and down along its side
5. Move to the other tooth in the pair and repeat
6. Use a fresh section for the next gap
7. Gums may bleed slightly the first 1–2 weeks; this decreases as gums heal

Common mistakes

• Skipping the back side of the last molar
• Straight up-and-down rather than curved around the tooth
• Skipping the gum line (where plaque meets tooth, not just the midpoint)
• Using the same section for every gap (reintroduces bacteria)
• Flossing once every few days instead of daily

Floss types

Waxed floss

Slides more easily between tight contacts. Good default.

Unwaxed

Slightly rougher, better grip on plaque. Good for patients without tight contacts.

PTFE (Teflon-style) floss

Ultra-thin, glides through very tight contacts. Good for crowns and orthodontic patients.

Floss picks

Hand-held plastic frame with floss. Hygienically worse (same floss for every gap) but better than nothing if traditional floss doesn't happen.

Interdental brushes — often better than floss

For gaps bigger than "very tight" contacts, interdental brushes (TePe, Curaprox) are proven more effective at plaque removal. The evidence now favours interdental brushes over floss for most adults with any interproximal space.

Choosing a size

Your hygienist fits the sizes — a pack typically includes 3–5 sizes for different gap widths. Use the largest that fits without forcing.

Water flossers (Waterpik, Oral-B Oxyjet)

Excellent for:

• Patients with braces, bridges, or implants
• Arthritis or limited dexterity
• Patients who just won't floss

Moderately effective as a primary interdental cleaner. Strong as a supplement to regular flossing or interdental brushing.

Our honest recommendation

• Tight spacing: waxed floss or PTFE floss daily
• Open spacing (small gaps): interdental brushes daily, floss in the few tight areas
• Braces / implants: water flosser + interdental brushes
• Low motivation: water flosser (better than nothing; habit-friendly)

When to floss — morning or night?

Night is better. You want clean interproximal surfaces for the 7–8 hours of reduced saliva during sleep. If you only floss once, make it at night.

Bleeding gums when flossing

Normal for the first 1–2 weeks. If bleeding continues beyond 3 weeks, you likely have gingivitis — see your hygienist.

References

• American Dental Association — Flossing recommendations
• Cochrane Review — Interdental cleaning