Let me get straight to the point here.
There has and will continue to be debate as to which is better for you, flossing or using water flossers like those made by Waterpik.
The simple answer is, you should use and stick with whichever you feel most comfortable with.
Providing you use either, daily, with the right technique, your oral health should improve.
However, it is useful to understand the differences and why you might want to try or use one over the other, so read on to find out about using a Waterpik vs Flossing.
Brushing your teeth cleans only 60% of the tooth surface.
That leaves some 40% of your teeth unclean and covered in residue food particles and bacteria.
Left untouched the bacteria grows to form a thick, sticky substance known as plaque.
Everyone develops plaque, some quicker than others, but it needs to be removed.
Failing to do so can lead to some quite significant health implications.
Red, sore and swollen gums are the first stages of gum disease.
Continue to do nothing and gum recession and even tooth loss is possible.
The answer is flossing.
What is flossing
Flossing is a word used to describe the process of cleaning the sides of teeth, including those hidden under the gumline, to remove plaque and bacteria, along with food particles that build up on these surfaces.
It is a process that will reach the 40% of tooth surface that regular brushing does not.
Typically, this is completed with a long and thin piece of nylon thread, named floss, hence the term ‘flossing’.
Flossing is often used interchangeably with the phrase ‘interdental cleaning’.
Interdental cleaning is much like flossing but is a broader term to describe the process of cleaning the space or gaps between teeth.
Commonplace today are ‘interdental brushes’ which fit in between teeth and clean the gaps (interdental spaces) between teeth using a series of bristles fitted around a handle and guide wire. We have covered these extensively in our guide to the best interdental brushes.
Typically, a floss will reach into the tightest of gaps and under the gumline where interdental brushes simply don’t fit.
Today there are many types of floss and interdental brushes on the market, amongst other tools, that help you and I clean these gaps effectively and with more ease.
All products have best use case scenarios and some target specific individuals, based on their needs and wants.
It is not uncommon for dentists to recommend a multitude of tools. Most often interdental brushes and floss, to clean the surfaces of the teeth that brushing alone does not reach.
Pros and cons to flossing
There are of course both benefits and drawbacks to flossing, some more valid than others.
Let’s take a look at some of the for and against arguments.
- Cheap – Generally very cost effective, typically under $5 a reel.
- Availability – Often easy to source from grocery stores and pharmacies.
- Can be completed anywhere – Whilst a mirror and a bathroom might be handy, it is not essential to allow you to floss.
- Physical contact – The floss makes physical contact with the tooth, scraping off the plaque and bacteria.
- Quick and easy – Relatively speaking, its is not the most difficult task to complete.
- It can be awkward to floss – Reaching in and around teeth whilst controlling the floss with fingers and thumbs can feel like a bit of a mission.
- It takes a good few minutes – To do it properly, takes time.
- You need the right technique to be effective – Simply putting the floss in between teeth is not enough. You need to cup around and move the floss for it to work, a technique that takes practice.
- My gums bleed when I floss – It can cut up and into the soft gum tissue and cause bleeding.
- It hurts to floss – As the floss passes under the gum, it can catch or touch with too much force, casing pain as you do it.
- Suitability – Not all floss or tools are suitable for one person, you may need multiple tools.
There is validity in all of these points.
I don’t think anyone would suggest that flossing is a glamorous task or indeed easy.
However, it is and will remain a very important recommendation as part of an oral hygiene routine.
Sadly, the most popular negatives to flossing come as a result of not flossing correctly in the first place.
The bleeding, the pain and the difficulty all subside if you floss daily and correctly, I can assure you of that.
Employ the technique detailed below, repeat daily and your oral health will be better.
How to floss
The exact approach you take to floss your teeth can vary slightly depending on the type of flossing product used and the size of the gaps between teeth.
When using regular dental floss, be that sting or tape, the approach to follow is as follows:
- Step 1: Pull out and cut off the reel of floss about 18 inches (45cm)
- Step 2: Wrap the ends around your two pointer fingers, and stretch it between them, so it is fairly taught, leaving about 6 inches between the two fingers.
- Step 3: Gently position the floss in between teeth, flex the floss slightly so it cups around the edge of one tooth in an C like shape. Move the floss up and down to get rid of plaque. Repeat this for the tooth on the other side of that same gap.
- Step 4: Repeat this for the tooth on the other side of that same gap.
- Step 5: Repeat this process for all teeth and gaps in the mouth.
- Step 6: Dispose of the floss.
The following video gives a good representation on how to floss.
The best floss
If I had to choose just 1 type of floss to recommend, it is Oral-B’s Glide Pro-Health Comfort Plus Floss.
Sliding easily between the teeth the tape is soft and has a minty freshness
The reel of floss measures 43.7yd (40m).
I have found it to be strong, but gentle enough for daily use. It is a great balance between performance and price.
|Oral-B Glide Pro-Health Comfort Plus Dental Floss, Mint, 43.7-Yard Dispenser, (Pack of 6)||210 Reviews||$19.99||View on Amazon|
Waterpik is the name of a brand, a company, a manufacturer.
They make water flossers or oral irrigators as they are otherwise known.
As the market leader, the Waterpik name has become synonymous with water flossing, but other brands do exist, albeit, Waterpik have the broadest range and arguably the best reputation.
What is water flossing?
An alternative to regular flossing, a water flosser uses a stream of pressurized water to dislodge and move the plaque, bacteria and food debris in between teeth and under the gumline.
Where regular string floss relies on the physical contact of the thread on the tooth surface, water flossing uses water molecules to do the same job.
A pump pulls water from a water tank on the unit, and pushes it out through a nozzle on the handle.
It is similar to, using a pressure washer to clean your deck. The pressure of the water dislodges, lifts and moves on the unwanted dirt.
Water flossers come in 2 main forms, countertop and cordless options.
Countertop tend to be the best, as they offer more of the benefits of water flossing.
Cordless are more convenient for some, particularly those that travel, whilst still offering some of the core features you expect of a water flosser.
Pros and cons to water flossing
Just like the string or tape floss, there are positives and negatives associated with water flossing.
They are as follows.
- Control – The handle and tip of the water flosser usually offers greater control and accuracy than string floss.
- Easier – The long nozzles reach into the mouth, particularly towards the back with much more ease than the hands and fingers do with string floss.
- Pressure – Variable pressure settings allow you to control how powerful the flow of water is on the teeth and gums.
- Massage/Sensitivity – Water is typically softer on the gum tissue and stimulates blood flow.
- Reach – The water molecules are pushed into gaps, particularly under the gumline that regular floss simply can’t reach.
- Orthodontics – Specialist tips or nozzles often aid cleaning of braces and dental appliances in a way string floss simply cannot.
- Cost – The initial purchase price is considerably more than a real of floss.
- Availability – Whilst sold in a wide range of stores, they are not as easy to source as standard floss.
- Size/Space – They are larger taking up countertop space.
- Power – Many require mains power to function.
- Portability – Bigger and bulkier to carry if travelling.
- Location – You generally need to be leant over a sink to drain away the water.
- Plaque removal – May not remove all plaque.
Water flossers are more expensive to buy, the do take up more space and do require you to use within a bathroom most of the time.
They are not as portable as traditional floss, but the convenience, efficiency and control they offer are very appealing.
How to use a Waterpik/water flosser
The setup and controls can differ slightly between countertop and cordless models, so do refer to the instruction manual.
As a general guide the process is as follows.
- Step 1: Fill the water tank/reservoir with lukewarm water (tank can be lifted out and replaced).
- Step 2: Fit the appropriate nozzle to the handle of the flosser ensuring it has clipped into place.
- Step 3: Adjust the pressure dial on the unit to your desired pressure level (can be adjusted later). If it’s your first time using, turn down to a lower setting.
- Step 4: Press the power button to switch the unit on.
- Step 5: Lean over the sink and place the tip of the flosser into your mouth. Close the lips enough to prevent splashing while still allowing water to flow from mouth into the sink.
- Step 6: Slide the switch on the handle from off to on, the water will begin to flow.
- Step 7: Aim water at the gumline at a 90 degree angle. Follow the gumline and pause briefly between teeth.
- Step 8: When complete, slide the button to ‘off’ and then press the power button to turn it off.
During the clean you can adjust the pressure, turn the nozzle and control water flow by sliding the switch to the on or off position during the clean.
Why not see how it is done on video:
The best water flosser
Out of all the water flossers available, if I were to chose one, it would be the Waterpik WP-660 Aquarius.
My water flosser buyer’s guide goes into a lot more detail and explanation as to how I come to such as decision, but it is the standard to beat in my eyes.
It offers all the desirable features with a 90 second run time, built in timer/pacer, water control button on the handle, 10 pressure settings and 7 tips included in the box,
Slimmer and quieter than other models too is a bonus.
Backed by many clinical studies and approved by the American Dental Association, the Aquarius is a great balance between features, size and price.
It does too come in a range of colours, so you need not be stuck with the standard White colour option.
So which is better?
In all honesty, it is not as simple as saying 1 is better than the other.
Personal circumstances can often play a part, which might make floss better suited to 1 person and water flosser better suited to another.
An example of this is, someone with limited hand and finger mobility will find a water flosser much more effective as controlling a piece of floss is simply not possible.
But to help find what is right for you, I will go into a little more detail and compare some of the pros and cons of both floss and water flossers.
Ease of use and convenience
You may feel differently, but once you have got used to either using a long thread of floss or the powerful jet of water, both are relatively easy to use,
Both become easier the more you use them and will often become second nature within a few weeks. However, most are able to perfect their water flossing technique quicker than the can flossing.
The long jet tips and nozzles found on a water flosser can make it easier to reach the back teeth and certain areas of the mouth, whereas trying to position floss between those back molars can be quite difficult moving the fingers and thumbs into the right place.
Wrapping the floss around fingers can be painful and keeping the tension and control on the floss can be much more difficult than directing a jet of water.
String floss certainly has the benefit that the small and compact reel fits comfortably in a pocket or a bag and although flossing in front of a mirror is helpful, it is not essential.
You can floss in the bathroom, in the car, on the bus, in the street or wherever you like really, providing you feel comfortable.
Water flossers on the other hand are larger and bulkier and most, unless cordless, will require mains power to function.
You tend to have to lean over a sink to give a place for the water to drain away into, so you won’t normally be using a water flosser whilst sat in the parking lot.
However, for the majority of us, we floss at home, in our bathrooms and although the idea of portability is nice, it is not actually that important.
Reels of floss can be gotten from the grocery store, pharmacy, maybe a local 7-Eleven, whereas you will have to get a water flosser from particular stockists.
A reel of floss is a few dollars whilst a water flosser is tens of dollars.
The cost of ownership of a water flosser tends to reduce the longer you have it and you can even share with other family members.
What you find easiest to use and more convenient will be personal opinion. Most find the Waterpik approach easier and more convenient for them, but having a reel of floss on hand can be useful if you are travelling or want to freshen up after eating lunch.
Effectiveness and clinical evidence
Whilst, this is not about me, I actually use both in my daily life.
It would be hard for me to say that 1 is better or worse than the other as I can only speak for how I feel after using each. I have not conducted any clinical trials or studies to say either way.
I find both to be effective, but the experience to be different.
Both approaches require the use of the correct technique to be beneficial and effective in the clean that they produce.
Using either, even without a 100% perfect technique is better than doing nothing at all but to achieve the best results, you need to perfect that technique.
In recent years the media in particular picked up on the fact that the U.S Dietary Guidelines issued in 2015, omitted flossing as a recommendation where it had previously.
The Associated Press looked at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings were that the evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.”
“The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal.”
The US government acknowledged the effectiveness of flossing had never been researched, as required, but the ADA was quick to issue a statement surrounding the media controversy.
“The bottom line for dentists and patients is that a lack of strong evidence doesn’t equate to a lack of effectiveness”.
To this day, evidence for flossing remains relatively weak, but water flossing has attracted more attention and study.
Waterpik have listed a large amount of clinical research on their website.
Highlights from this research are:
- 2005 study that found a Waterpik water flosser to be 51% more effective than string floss in reducing Gingivitis (gum disease)
- 2009 study by Gorur et al that found that a Waterpik water flosser removed 99.9% of plaque biofilm after a 3 second treatment
- 2011 study that a water flossers was twice as effective as string floss for reducing gingival bleeding.
- 2013 study by BioSci Research in Canada, that found the Waterpik water flosser was 29% more effective than string floss for overall plaque removal, 29% for approximal surfaces, and 33% for marginal surfaces.
Dentists may traditionally have recommended floss over water flossing, it would appear that this might have been more of an academic backed recommendation than one based on research.
As you will see later in this article, opinion is still divided but if we read in between the arguments both have merit, but it is the water flossing, particularly Waterpik products that are backed by the research.
What dentists and health professionals really want is for the population to take more care of their teeth and both approaches help with this.
- Clean the areas of the teeth (up to 40%) that regular brushing does not reach.
- Dislodge trapped food particles
- Remove plaque and bacteria
- Reach under the gumline where bacteria can become trapped
- Can help prevent tartar build up
- Can help reduce the chances of gum disease
- Make your mouth feel cleaner and fresher
You might be surprised to read that by failing to floss, you are increasing the likelihood of irritation, pain and bleeding when you do.
Plaque and bacteria that is not disrupted and removed, can over time begin to irritate the gums and surrounding tissue. This in turn can cause them to swell, become more Red in colour and bleed more easily.
Therefore, when the floss moves into the area that contains the plaque and touches the soft gum tissue it can cut in and cause bleeding and associated pain.
Regular flossing, be that with string floss, an interdental brush or water will stop the buildup and the associated irritation.
Within just a couple of weeks or regular cleaning, gums once Red, sore and bleeding will reduce and the floss will travel around the tooth and under the gum with more ease. The pain will subside and it will be pain free.
What the power flossers like that from Waterpik offer is control over the pressure. You can often choose between low or high pressure and adjust the settings to something you are comfortable with. This makes for a less painful experience, because the water is softer than the physical contact of the floss.
So all told, the complaints about pain and bleeding are only so, because you are not already flossing, or not doing it properly.
Both flossing or using a Waterpik should be done at least once a day.
Last thing at night before bed, tends to be the best time.
There is no harm in flossing more often, but the benefits might not be as great.
The time taken to use string floss or a water flosser is often very similar, if you are flossing correctly.
By no means an exact time, most people will take 1-2 minutes to floss thoroughly.
You might save a little time with a water flosser.
I believe it is easier to perfect the technique of water flossing and many units offer around 90 seconds of usage time from a tank of water.
With practice, you might be able to floss in just 30 seconds, but it is not a race.
You are better to do it slowly and correctly than fast and poorly.
Is using a Waterpik a substitute for flossing?
The research would suggest that water flossing is a perfectly suitable substitute for flossing, it’s just a different way of doing it.
To some extent though, it will depend in part on your teeth and your preferences.
Those with particularly tight gaps might actually find string floss to be better for them.
For some people, like me, using both is a great combination.
It is fair to take your dentist’s advice over that of a friend or something you read on the internet. However, do bear in mind some dentists have their preferred ways and are not necessarily open to alternatives.
But, as I have already stated, it is more about doing something, than nothing. If that something is using a Waterpik, then you should get the approval of your dentist.
What the dental professionals say
The following are opinions from some dental professionals, you will see many have slightly different views, but all focus on the importance of interdental cleaning.
Whether you choose to use a water flosser or the traditional string floss method, you are positively contributing to your overall health. Healthy gums and teeth lead to a healthy heart and life! – Fredricksburg Smile Center
Some studies have shown water flossing to be more effective at cleaning teeth, but the most important thing is to clean between your teeth and under your gums every day, no matter the method. – Caffaratti Dental Group
If you have great flossing technique and use it everyday and have no teeth or gum problems, keep using string floss. But, if you hate to floss or are not good at flossing, oral irrigators are a great way to clean between your teeth. – Shelly Fesler
Whether you ultimately choose to use dental floss or a water flosser, please brush, floss, and rinse your teeth with mouthwash every day. – Rudy Wassenaar
Waterpiks are readily available for patients who are seeking a more effective way of addressing food particles between the teeth. However, waterpiks alone are unable to remove plaque. They only rinse the area. Waterpiks are better than not flossing at all, but they should be combined with a regular routine of using dental floss as well to ensure a healthier smile. – Viva Smiles
Waterpiks do a great job of flushing food and debris out from between teeth, under braces and arch wires, and especially under and around fixed (non-removable) bridges….Unfortunately, they DO NOT remove plaque (bacterial colonies) like floss does because effective flossing literally “wipes” the sticky plaque off teeth and Waterpiks can only “rinse” these areas. However, combining both flossing and Waterpiks can achieve great results! Folks with dexterity problems or people who will just never floss will greatly benefit from Waterpik use and it is definitely better than doing nothing. – Dr Langberg
Using the Water Flosser and traditional string floss together achieves the best result, however some people do very well with a Water Flosser alone. – Christianne Cassinelli
Clinical studies have and will continue to drive further debate, but what is not up for debate is the importance of interdental cleaning.
If you already floss daily, are in a routine of doing so and can keep it up, then great.
If you have never flossed, or do so rarely, then the Waterpik or equivalent water flosser will likely help you make this a routine because it addresses for most people the biggest complaint of flossing in the first place.
You may choose to use both!
All things considered, it is about finding what works for you.
Most dental professionals may have a preference and those preferences are naturally divided.
However, when it comes down to it, they would prefer you do something rather than nothing.
So, whether you use string floss or water floss each day, both contribute to good overall oral health.