Interdental cleaning

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Interdental cleaning or interproximal cleaning is part of oral hygiene where the aim is to clean the areas in between the teeth, otherwise known as the proximal surfaces of teeth. This is to remove the dental plaque in areas a toothbrush cannot reach. The ultimate goal of interproximal cleaning is to prevent the development of interproximal caries and periodontal disease. The combined use of tooth brushing, and mechanical and manual interdental cleaning devices has been proven to reduce the prevalence of caries and periodontal diseases. [1] [2]

Contents

Floss

Dental floss Dental floss (whole).jpg
Dental floss

Floss is one of the most commonly used interdental cleaners. It is traditionally made of waxed nylon wrapped up in a plastic box. Since dental floss is able to remove some inter-proximal plaque, frequent regular dental flossing will reduce inter-proximal caries and periodontal disease risks. [1] [3] Results of a high level of evidence meta-analysis recently found that floss may not be the most effective method for interdental cleaning, contrary to common belief at the time. [4] Especially for individuals lacking dexterity or compliance, waterjet irrigators, and interdental brushes were found to be significantly more effective than flossing. [4]

Interdental brush

Wire-and-nylon interdental brushes in a range of sizes TePe Interdental Brushes original.jpg
Wire-and-nylon interdental brushes in a range of sizes
Rubbery interdental brush Tandenrager.jpg
Rubbery interdental brush

Interdental brushes commonly consist of either a central metal wire core with soft nylon filaments twisted around, or an elastomer, and are available in various sizes to correspond to different spaces between teeth. Certain factors such as material, geometry and size of the brush can be chosen to optimize the efficiency and effectiveness:

Oral irrigator

A Water Pik water flosser Water Flosser.jpg
A Water Pik water flosser

Oral Irrigators (also called water flossers) are common mechanical tools used for interdental cleaning. It uses a combination of pulsation and pressure facilitated by water or air to remove debris and bacteria both above and below the gums. [6] When used with tooth brushing, the use of oral irrigators reduces inflammation of the gums (gingivitis) by removing loosely adherent plaque. It is also beneficial for implant maintenance as there is less bleeding around implants when oral irrigators are used compared to dental floss. [7] [5]

Toothpick

Toothpicks are thin sticks made from various materials that insert into the interdental space for cleaning. Although there is a long history of use dating back to 1.8 million years ago, [8] dentists generally recommend against their use due to a perceived danger of causing mechanical damage to gum, enamel, and tooth roots. [9]

Related Research Articles

<span class="mw-page-title-main">Human tooth</span> Calcified whitish structure in humans mouths used to break down food

Human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.

<span class="mw-page-title-main">Periodontal disease</span> Medical condition

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Halitosis may also occur.

<span class="mw-page-title-main">Toothbrush</span> Oral hygiene tool

A toothbrush is an oral hygiene tool used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They should be used in conjunction with something to clean between the teeth where the bristles of the toothbrush cannot reach - for example floss, tape or interdental brushes.

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

<span class="mw-page-title-main">Tooth decay</span> Deformation of teeth due to acids produced by bacteria

Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors, from yellow to black. Symptoms may include pain and difficulty eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation. Tooth regeneration is an on-going stem cell based field of study that is trying to reverse the effects of decay, unlike most current methods which only try to make dealing with the effects easier.

<span class="mw-page-title-main">Dental floss</span> Cord of thin filaments used in interdental cleaning

Dental floss is a cord of thin filaments used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use as part of oral cleaning is intended to maintain oral health.

<span class="mw-page-title-main">Toothpick</span> A small stick for cleaning teeth

A toothpick is a small thin stick of wood, plastic, bamboo, metal, bone or other substance with at least one and sometimes two pointed ends to insert between teeth to remove detritus, usually after a meal. Toothpicks are also used for festive occasions to hold or spear small appetizers or as a cocktail stick, and can be decorated with plastic frills or small paper umbrellas or flags.

<span class="mw-page-title-main">Gums</span> Soft tissue surrounding the roots of the teeth

The gums or gingiva consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.

<span class="mw-page-title-main">Oral irrigator</span> Dental care device

An oral irrigator is a home dental care device which uses a stream of high-pressure pulsating water intended to remove dental plaque and food debris between teeth and below the gum line. Regular use of an oral irrigator is believed to improve gingival health. The devices may also provide easier cleaning for braces and dental implants. However, more research is needed to confirm plaque biofilm removal and effectiveness when used by patients with special oral or systemic health needs.

<span class="mw-page-title-main">Tooth brushing</span> Act of scrubbing teeth with a toothbrush

Tooth brushing is the act of scrubbing teeth with a toothbrush equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene. The recommended amount of time for tooth brushing is two minutes.

<span class="mw-page-title-main">Gingival and periodontal pocket</span>

Gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival tissue contacts the tooth.

Bleeding on probing (BoP) which is also known as bleeding gums or gingival bleeding is a term used by dentists and dental hygienists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth. BoP is a sign of periodontal inflammation and indicates some sort of destruction and erosion to the lining of the sulcus or the ulceration of sulcular epithelium. The blood comes from lamina propria after the ulceration of the lining. BoP seems to be correlated with Periodontal Inflamed Surface Area (PISA).

<span class="mw-page-title-main">Scaling and root planing</span> Dental procedure

Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning, is a procedure involving removal of dental plaque and calculus and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms, the agents that cause inflammation. It is a part of non-surgical periodontal therapy. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.

<span class="mw-page-title-main">Oral hygiene</span> Cleaning the mouth by brushing the teeth and cleaning in between the teeth

Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

<span class="mw-page-title-main">Tongue cleaner</span> Oral hygiene device

A tongue cleaner is an oral hygiene device designed to clean the coating on the upper surface of the tongue. While there is tentative benefit from the use of a tongue cleaner it is insufficient to draw clear conclusions regarding bad breath.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

<span class="mw-page-title-main">Periodontal abscess</span> Medical condition

A periodontal abscess, is a localized collection of pus within the tissues of the periodontium. It is a type of dental abscess. A periodontal abscess occurs alongside a tooth, and is different from the more common periapical abscess, which represents the spread of infection from a dead tooth. To reflect this, sometimes the term "lateral (periodontal) abscess" is used. In contrast to a periapical abscess, periodontal abscesses are usually associated with a vital (living) tooth. Abscesses of the periodontium are acute bacterial infections classified primarily by location.

Periodontal surgery is a form of dental surgery that prevents or corrects anatomical, traumatic, developmental, or plaque-induced defects in the bone, gingiva, or alveolar mucosa. The objectives of this surgery include accessibility of instruments to root surface, elimination of inflammation, creation of an oral environment for plaque control, periodontal diseases control, oral hygiene maintenance, maintain proper embrasure space, address gingiva-alveolar mucosa problems, and esthetic improvement. The surgical procedures include crown lengthening, frenectomy, and mucogingival flap surgery.

References

  1. 1 2 Hujoel, P.P.; Cunha-Cruz, J.; Banting, D.W.; Loesche, W.J. (2006). "Dental Flossing and Interproximal Caries: a Systematic Review". Journal of Dental Research. 85 (4): 298–305. doi:10.1177/154405910608500404. ISSN   0022-0345. PMID   16567548. S2CID   53789465.
  2. Sambunjak, Dario; Nickerson, Jason W.; Poklepovic, Tina; Johnson, Trevor M.; Imai, Pauline; Tugwell, Peter; Worthington, Helen V. (2011-12-07). "Flossing for the management of periodontal diseases and dental caries in adults". The Cochrane Database of Systematic Reviews (12): CD008829. doi:10.1002/14651858.CD008829.pub2. ISSN   1469-493X. PMID   22161438.
  3. Bagramian, Robert A.; Garcia-Godoy, Franklin; Volpe, Anthony R. (2009). "The global increase in dental caries. A pending public health crisis". American Journal of Dentistry. 22 (1): 3–8. ISSN   0894-8275. PMID   19281105.
  4. 1 2 Kotsakis, Georgios A.; Lian, Qinshu; Ioannou, Andreas L.; Michalowicz, Bryan S.; John, Mike T.; Chu, Haitao (2018). "A network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation". Journal of Periodontology. 89 (5): 558–570. doi:10.1002/JPER.17-0368. ISSN   1943-3670. PMC   5984142 . PMID   29520910.
  5. 1 2 Ng, Ethan; Lim, Lum Peng (2019-06-01). "An Overview of Different Interdental Cleaning Aids and Their Effectiveness". Dentistry Journal. 7 (2): 56. doi: 10.3390/dj7020056 . ISSN   2304-6767. PMC   6630384 . PMID   31159354.
  6. MS, AEGIS Communications, By Deborah M. Lyle, RDH, BS. "Use of a Water Flosser For Interdental Cleaning | Compendium". Dental Network. Retrieved 2023-05-10.{{cite web}}: CS1 maint: multiple names: authors list (link)
  7. Worthington, Helen V; MacDonald, Laura; Poklepovic Pericic, Tina; Sambunjak, Dario; Johnson, Trevor M; Imai, Pauline; Clarkson, Janet E (2019-04-10). "Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries". Cochrane Database of Systematic Reviews. 2020 (4): CD012018. doi:10.1002/14651858.cd012018.pub2. ISSN   1465-1858. PMC   6953268 . PMID   30968949.
  8. Hogenboom, Melissa (8 October 2013). "'Ancient humans' used toothpicks". BBC News. Retrieved 29 August 2021.
  9. "But It's Just a Little Toothpick, How Threatening Can It Be". Northern Dental Design. 10 June 2021.