I'm gonna [pik or floss] that plaque right off of my teeth
September 1, 2012 9:50 AM   Subscribe

WaterPik or floss: Which is more effective?

Comparing WaterPik vs floss for EFFECTIVENESS.
All things being equal -- once a day, same time, proper technique, used in combo with toothbrushing, etc -- which is better at removing plaque?
posted by LonnieK to Health & Fitness (13 answers total) 6 users marked this as a favorite
I originally got told to use both from the hygenist, so....

That said: I stopped using the WaterPik early on--I always forget to charge the stupid thing and refill it before I go back into the shower--and I still haven't had any cavities come up in the last several years. So I guess it isn't 100% mandatory in the end.
posted by jenfullmoon at 10:09 AM on September 1, 2012

For best results using both, but the reality is that you have to be disciplined to use it. My choice is to floss, but I do other regimes that are now a habit for me. I also swish with olive oil for about 5 minutes after I floss; it gives me the just-got-a teeth-cleaning feel. Then I brush with toothpaste, then I rinse with a combo of water and hydrogen peroxide and finish it off with a tongue scraper. It sounds like a lot, but it sure is easier for me that remembering to use the water pik. This gives me fresh breath all day and evening long. I skip the whole regime on some days when not at home, but I always floss.
posted by i_wear_boots at 10:19 AM on September 1, 2012 [1 favorite]

Floss win.
posted by pla at 10:23 AM on September 1, 2012 [1 favorite]

I asked my dentist this question just recently and was told to go with the traditional floss (and this was not an "old school" dentist but rather one that has all the new technology in the office).
posted by belau at 10:24 AM on September 1, 2012

As an experiment, I suspended my flossing and relied only on my waterpik for a couple weeks before a routine cleaning. My hygienist said I wasn't flossing enough.
posted by germdisco at 11:03 AM on September 1, 2012

Our dentist says the waterpik is better for your gums but doesn't replace flossing, so another vote for floss.
posted by waterlily at 11:52 AM on September 1, 2012

My dental hygienist sister says to floss if you're going to choose.
posted by PorcineWithMe at 1:03 PM on September 1, 2012

Waterpik is more likely to reduce bleeding and gingivitis compared to floss, otherwise similarly effective[1].
There are many studies involving Waterpik usage, so use Google Scholar or whatever else to find more information.

I recently participated in a Waterpik study at my university, and was paid $150 to brush my teeth and floss twice a day for 2 weeks, so that's what inspired me to search scholarly articles.
posted by oceanjesse at 2:48 PM on September 1, 2012

I did a brief survey of Medline on this and the literature is mixed. A Waterpik-sponsored study concluded:

“when combined with manual or sonic tooth brushing, oral irrigation is an effective alternative to manual tooth brushing and dental floss for reducing bleeding, gingival inflammation, and plaque removal.”

Floss I suspect is better for removing plaque / biofilms because of the direct mechanical scraping.

There is a also a recently concluded as yet unpublished UNC study of your question (sponsored by Philips Oral Healthcare, makers of Sonicare) which I suspect will come out soon.

For perhaps less biased answers, the Academy of General Dentistry says floss is better because it removes plaque, and water irrigation does not. However irrigation may be better for under the gum infection and irritation.

“Don't use waterpicks as a substitute for brushing and flossing. But they are effective around orthodontic braces, which retain food in areas where a toothbrush cannot reach. However, they do not remove plaque. Waterpicks are frequently recommended by dentists for persons with gum disease; solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist's prescription, can be added to the reservoir in these cases.”
posted by zippy at 2:56 PM on September 1, 2012

Zippy, that advice by the Academy of General Dentistry is outdated.

It turns out that there is little good evidence that floss helps very much with plaque removal: see the 2012 systematic review by Cochrane.

To quote the study: "Overall there is weak, very unreliable evidence which suggests that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 or 3 months." According to the Cochrane review, the benefit of flossing is for preventing gingivitis and bleeding gums.

I won't comment on Waterpik, but without decent evidence (not shitty in-house studies), I would be hesitant in assuming it is any better at plaque removal than flossing.
posted by dontjumplarry at 5:32 PM on September 1, 2012

To clarify: flossing is still important for preventing gum disease but don't fool yourself that it's helping with plaque removal.

If you want an extra technique to actually help prevent cavities, a professor of dentistry told me recently that the best thing you can do is simply to rinse your mouth with the toothpaste slurry for 1 minute after brushing, to ensure the fluoride reaches the hard-to-access parts of your mouth where cavities are most likely to occur. (A technique tested in this study.)

posted by dontjumplarry at 5:41 PM on September 1, 2012 [1 favorite]

Hand floss. Don't just jam it between your teeth and pull it back up. You'll want to "scrub" up and down one wall/side of the gap, then "scrub" the other side between each tooth. Also, work gently into the gumline.

Get a Philips Sonicare - spend at least 10 seconds on each side (front/back) of each tooth. This is equivalent to about 30-60 seconds of manual toothbrushing.

Yeah, the way hygienists tell it, cleaning your mouth takes a really long time. And at least twice a day.
posted by porpoise at 7:38 PM on September 1, 2012

dontjumplarry, that's really interesting. Here's another meta-analysis from 2008 that says flossing does no good for both plaque and gingivitis (in the presence of brushing). Hard to believe, but:

The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review. Berchier et al, Int J Dent Hyg. 2008 Nov;6(4):265-79.

OBJECTIVES: The aim of this study was to assess systematically the adjunctive effect of both flossing and toothbrushing versus toothbrushing alone on plaque and gingivitis.

CONCLUSIONS: The dental professional should determine, on an individual patient basis, whether high-quality flossing is an achievable goal. In light of the results of this comprehensive literature search and critical analysis, it is concluded that a routine instruction to use floss is not supported by scientific evidence.
posted by zippy at 10:19 PM on September 1, 2012 [1 favorite]

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