The importance of flossing: why it's essential for your oral health

A survey by the Australian Dental Association found that around three quarters of Australians do not clean between their teeth. It is the most commonly skipped step in oral hygiene, and it is also the one that protects the surfaces where most problems actually begin.

Why brushing alone is not enough

A tooth has five surfaces. A toothbrush reaches three of them — the outer, inner and chewing surfaces — which is roughly 60% of each tooth.

The remaining two are the surfaces where each tooth touches its neighbours. Bristles cannot get in there, and those contact points are precisely where decay and gum disease most commonly start: they are sheltered, they trap food, and they are invisible to you in the mirror.

That is the whole argument. Not that flossing is virtuous, but that 40% of every tooth goes untouched without it.

What it actually prevents

Decay between teeth. One of the most common sites for cavities, and one you cannot see. It is found on X-rays, usually once it already needs a filling.

Gum disease. Inflammation begins where plaque sits undisturbed against the gum, which is most often between the teeth. Gingivitis at that stage is fully reversible; once it progresses to periodontitis and bone is lost, it is not.

Bad breath. Trapped food and bacteria between teeth are a common cause. Cleaning between teeth helps considerably — though we would not claim it eliminates the risk, since persistent bad breath can also come from the tongue, dry mouth, sinus conditions, reflux or medication. If it persists despite good cleaning, mention it rather than covering it up.

What it does not do

Worth being straight about, because overclaiming is why people stop believing dental advice.

Flossing does not whiten teeth, remove tartar once it has hardened, or prevent decay on the chewing surfaces — that is what brushing and sealants are for. It does not treat existing gum disease on its own, and it will not rescue a tooth that already needs a filling.

What it does is stop new problems starting on two surfaces per tooth that nothing else reaches. That is enough.

Floss is not the only option

What matters is that the space gets cleaned, not which tool does it. Use whichever you will actually use daily.

Interdental brushes (Piksters and similar) are more effective than floss for most people who have gaps large enough to take them, and most people find them considerably easier. They come in sizes; ask us which fits your spaces — the wrong size either will not go in or does not touch the sides.

Floss is the right choice where teeth are tight against each other and a brush will not pass.

Floss picks are easier to handle, particularly for back teeth, though the fixed angle makes it harder to curve around each tooth properly.

Water flossers suit people with braces, bridges or implants, or with limited dexterity. Easier to use, though generally less thorough than floss or interdental brushes on a tight contact.

Tool	Best for	Watch out for
Interdental brushes	Most adults with visible gaps	Using the wrong size, which does nothing
String floss	Tight contacts	Snapping it into the gum
Floss picks	Back teeth; limited dexterity	The fixed angle makes the C-shape hard
Floss threaders / superfloss	Under bridges, around implants and braces	Nothing else reaches under a bridge
Water flosser	Braces, bridges, implants, arthritis	Flushes well; less effective at disrupting stuck biofilm
Wooden or plastic picks	Dislodging trapped food on the go	Not a substitute for cleaning the surfaces

Most people need two of these, not one — typically interdental brushes for the back gaps and floss for the tight front ones.

Choosing floss

Waxed slides through tight contacts more easily and shreds less
Unwaxed squeaks when the surface is clean, which some people like as feedback
PTFE / tape is best for very tight contacts and for anyone who keeps shredding floss
Flavoured or unflavoured makes no difference to the cleaning
Shredding in the same spot every time is worth mentioning to us — it usually means a rough filling edge or a small cavity

How to floss properly

Take about 30–40cm of floss and wind most of it round the middle finger of each hand.
Hold a short section taut between thumbs and index fingers.
Guide it gently between the teeth — do not snap it down, which cuts the gum.
Curve it into a C-shape against the side of one tooth and slide it gently just below the gumline, then up. Then repeat against the neighbouring tooth. This is the step most people miss: a straight up-and-down motion cleans neither surface properly.
Use a fresh section as you move along.
Do not forget the back surface of the last molar on each side.

Once a day is enough. Before bed is ideal, since saliva flow drops overnight. Whether you floss before or after brushing matters far less than whether you do it — though doing it first means the fluoride toothpaste reaches the spaces you have just cleaned.

Using an interdental brush

Simpler, and worth spelling out because people often use the wrong size for years.

Choose a size that meets slight resistance. Too loose does nothing; too tight hurts and can damage the gum
Insert straight in, gently, at the gum line. Do not force it
In and out a few times. No toothpaste needed
Angle it slightly for back teeth, and use the handle bend rather than forcing the wire
Rinse it and move on. Replace the brush weekly, or sooner if the wire bends

We can size you in a minute at your next appointment. It is the single most useful thing to ask for, and almost nobody does.

If your gums bleed

They often do when you first start, and that puts a lot of people off permanently. Bleeding is a sign of existing inflammation, not of damage you are doing. The gums are inflamed because plaque has been sitting there.

Keep going, gently. It usually settles within one to two weeks as the inflammation resolves. If it is still bleeding after that, or if bleeding is heavy or comes from one specific spot, come and see us — that needs looking at.

If you take blood thinners, expect a little more bleeding and tell us. It is not a reason to stop cleaning.

Around dental work

Bridges. Nothing gets under a bridge except a floss threader or superfloss. Ordinary floss cannot pass through, and the space under the false tooth is exactly where problems start.

Implants. Clean around the neck of the implant carefully every day. Peri-implantitis — gum disease around an implant — is the main reason implants are lost, and it is quiet early on.

Braces. A floss threader or orthodontic floss to get under the wire, plus an interdental brush. This is a genuine chore; a water flosser alongside it makes it more likely to actually happen.

Crowns and veneers. Floss normally, but slide it out sideways rather than pulling it straight up through a tight contact, particularly with a new restoration.

Dentures and partial plates. Clean the plate separately, and clean the natural teeth the clasps sit on with particular care — those are the teeth most at risk.

Children

Start cleaning between the teeth as soon as two teeth touch, usually somewhere between two and four years old. Floss picks are easier in a small mouth. Once a day, at night, gently, and you do it — not them — until around seven or eight.

If it turns into a fight, clean the two back contacts and leave the rest. That is where the decay happens.

Making it stick

Most people who do not floss are not lazy; they have just never made it automatic. What tends to work: keep the floss or Piksters somewhere visible rather than in a drawer, attach it to an existing habit, and start with the teeth you can reach easily rather than aiming for perfection on night one.

A few more things that help:

Do it before brushing, so it is not the thing standing between you and bed
Do it sitting down, in front of the television if the bathroom is where the resolve fails
Keep a pack in the car, the desk drawer and the bag, not only in the bathroom
Aim for six nights out of seven, not perfection. A run that survives one missed night survives
Give it three weeks. It gets faster, and it stops feeling like a production

If you find flossing genuinely difficult — large hands, small mouth, limited dexterity, arthritis — say so at your next appointment. There is almost always a tool that works better for your particular mouth, and we would rather find it than have you give up.

Questions we are asked

Do I really have to do it every day? Plaque takes about a day to organise itself into something that irritates the gums. Once a day stays ahead of it; twice a week does not.

Before or after brushing? Either. Before is marginally better, because the fluoride then reaches the cleaned spaces.

My teeth are tight and floss shreds. Use PTFE tape, and tell us — shredding in one spot usually means something rough is there.

Is a water flosser enough on its own? Better than nothing, and genuinely good around braces and bridges. For most people it works best alongside floss or interdental brushes.

I have gaps between my teeth. Do I still need to? More than most people. Larger spaces trap more, and interdental brushes are ideal.

It makes my gums sore. Gently, and check the size of the brush. Soreness for the first week is common; ongoing pain is not, and needs looking at.

Does flossing create gaps? No. What it does is remove inflammation, so swollen gums shrink back to their proper shape — which can reveal a space that was already there.

Who provides this here

Victorian Dental Group is a general dental practice in Malvern East and holds no specialist registration. At a check-up and clean our dentists and oral health therapists will size interdental brushes for your mouth and show you the technique on your own teeth, which is worth considerably more than any page. Ask us to.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · book online

General information only, not personal dental advice. See our disclaimer.

Why is brushing alone not enough?

Because a toothbrush physically cannot get between two teeth that are touching. Those contact surfaces are where decay between teeth starts and where gum disease begins, and no amount of extra brushing reaches them. That is the whole case for cleaning between the teeth — it is about access, not effort.

How often should I do it?

Once a day is enough, and doing it well once beats doing it hurriedly twice. Before bed is the best time, since anything left overnight has the longest to do damage.

What is the right technique?

Take about 40cm of floss, wind most of it around the middle fingers and hold a short section taut between thumbs and index fingers. Guide it gently between the teeth with a back-and-forth sawing motion rather than snapping it down onto the gum. Then curve it into a C shape against the side of one tooth, slide it just under the gum margin, and move it up and down a few times. Repeat against the neighbouring tooth, and use a fresh section of floss as you work around.

Is floss the only option?

No, and it is often not the best one. Interdental brushes — small tapered brushes in various sizes — are easier to handle and clean more effectively wherever the gaps are big enough to take one, which is most adults with any gum recession. Floss picks suit tight contacts and awkward back teeth. A water flosser helps around bridges, implants and braces. The best method is the one you will actually use every day.

My gums bleed when I floss — should I stop?

No, keep going. Gums that are already inflamed bleed when first disturbed, and that usually settles within one to two weeks as the inflammation resolves. Stopping lets the plaque rebuild. Be gentle and avoid snapping the floss down. If bleeding persists beyond a couple of weeks, have it assessed rather than continuing indefinitely.

Before or after brushing?

Either works and consistency matters more, but flossing first has a reasonable argument: it loosens debris and lets the fluoride toothpaste reach between the teeth afterwards. Whichever you choose, spit the toothpaste out rather than rinsing at the end.

Will it help my breath?

It usually helps a good deal, because trapped food and plaque between the teeth are a common source of odour. It will not guarantee fresh breath on its own — the back of the tongue holds the largest share of the bacteria responsible, so cleaning that matters too, and persistent bad breath despite good cleaning should be looked into.

What if I find it difficult?

Say so and ask to be shown — technique is much easier demonstrated than described, and most people who say they cannot floss are using the wrong tool for their gaps. Floss holders, picks and interdental brushes all make it easier, as does an electric brush for the rest of the job. Victorian Dental Group, 291 Wattletree Road, Malvern East VIC 3145 — (03) 9088 5808, Monday to Friday 8:00am to 5:00pm.