Interdental Brushes vs Floss: Which Actually Works Better?

The evidence shift

For decades, floss was the default interdental cleaner recommendation. Recent Cochrane meta-analyses show interdental brushes are at least as effective, and often more effective, at plaque removal and gingivitis reduction when gaps are large enough to accommodate them.

When interdental brushes win

• Any visible gap between teeth
• Triangular spaces below the contact point
• Around implants (much better than floss)
• Under bridges (with a single or threader brush)
• Around braces

When floss still wins

• Very tight tooth contacts where no brush fits
• Young adults with uniformly tight spacing
• As a supplement to brushes in specific tight areas

How to size brushes

Your hygienist uses a colour-coded probe to fit the right size per space. A multi-size pack (TePe, Curaprox) covers most adults — typically 3–5 different sizes in rotation.

Rule of thumb: use the largest brush that fits without forcing.

Technique

1. Insert gently, not forced
2. Brush in and out 2–3 times per space
3. Rinse the brush between gaps to avoid reintroducing bacteria
4. Once-daily at minimum, ideally at night
5. Replace the brush when bristles splay (typically 1–2 weeks)

Cost

Packs of 10–30 brushes: AED 40–100. Daily cost: ~AED 1.

Common resistance points

• "I've always flossed." That's fine if it's effective. Many adults would benefit from the switch, especially if gaps exist.
• "Brushes feel awkward." Take 2 weeks to adapt. Most patients prefer them after that.
• "I can't find the right size." Have your hygienist fit them at your next visit.

Combining techniques

The best routine for many adults:

• Larger posterior gaps: interdental brushes
• Tight anterior contacts: floss or picks
• Around implants and crowns: interdental brushes with rubber tip
• Water flosser as evening supplement

For braces and ortho patients

Interdental brushes are the single best supplementary tool during orthodontics. Use after every meal where possible.

References

• Cochrane — Interdental cleaning methods
• Journal of Clinical Periodontology — Long-term plaque reduction