Flossing is an essential part of removing the dental plaque between teeth that can lead to tooth decay and gum disease. It helps clean areas of the teeth that a toothbrush cannot reach, and also cleans debris from below the gumline. Flossing can be performed either before or after brushing the teeth. Everyone should floss at least once a day in addition to brushing twice daily, according to the American Dental Association (ADA). Some studies suggest that flossing twice per day may be more beneficial than flossing only once daily. A child’s teeth need to be flossed once the child develops teeth that touch.

Many people think flossing is intended to remove the debris from between a person’s teeth. However, the main purpose of flossing is to remove plaque by scraping the tooth surface. Plaque is the substance formed when bacteria occurring naturally in the mouth combine with food debris, saliva and acid. In addition to removing plaque, flossing helps remove food debris from teeth and gums, polish tooth surfaces and control bad breath (halitosis).

During flossing, it is important to clean below the gumline. However, this should be done with care. Never snap the dental floss into the gums because this can cause injury. People who are flossing for the first time or after a prolonged period of not flossing often bleed from the gums and may experience soreness for a few days. This is normal, and it usually stops after flossing removes all the accumulated bacteria. If soreness continues for more than six days, the patient should consult a dentist.

Dental floss is available in either unwaxed or waxed form. Studies have found that all types of floss are about equally effective at removing plaque, and that patient preference should dictate which form of floss is used. Unwaxed dental floss provides more friction for cleaning, and because the floss is thinner it tends to slip between the teeth more easily. Waxed floss tends to resist tearing and shredding better, especially when flossing through restorations or tight spaces between teeth.  

Other types of floss include polytetrafluoroethylene-type floss, dental tape or ribbon and braided nylon floss. In addition, dental floss is available in flavored or unflavored varieties and wide and regular types. Special floss threaders and types of floss are available for people with braces, who need to use particular types for thorough flossing. Interdental picks are also available to remove plaque between teeth, but may not provide as thorough cleansing.

People are urged to choose the floss that is most appropriate for them. For example, the wider floss, also called dental tape, is often used by people with bridges or people who have especially wide spaces (diastema) between their teeth. In some cases, patients may need to experiment with different types of flosses before finding the type that is appropriate for them. Some people with severe periodontal disease experience significant pain during flossing, and a dentist may recommend that certain patients use an irrigating device (water pick) instead of floss. Patients with braces may want to supplement flossing with water irrigation to ensure that all debris in tiny tooth recesses is thoroughly removed.

Most experts agree that manual flossing is the most effective method of removing plaque between teeth. Electric flossers are generally recommended only for people who have a disability or another factor that prevents them from flossing manually. Irrigating devices such as water picks do not remove plaque, although they may help clear the teeth of some food debris. In addition, the ADA continues to recommend daily flossing despite recent claims that some mouth rinses may be as effective as flossing at removing plaque.

It can take time to get used to flossing. However, people quickly become more proficient as they gain more experience. Children typically are able to floss without assistance by the time they reach the age of 10.