4 Tips for Good Interdental Hygiene

Good interdental hygiene removes bacterial plaque from the space between the teeth. We'll tell you how to achieve it according to science.

Written and verified by la odontóloga Vanesa Evangelina Buffa.

Last update: 07 November, 2023

Good interdental hygiene is a practice that shouldn’t be overlooked if you want to keep your mouth healthy. Proper care of the area between each tooth prevents many complications but requires special attention.

The bacterial plaque that accumulates in the space between the teeth predisposes people to the appearance of oral problems such as cavities, gingivitis, periodontitis, and bad breath. These affect the quality of life of those who suffer from them and can aggravate other health conditions.

Maintaining good interdental hygiene can be complicated by its difficult access. In this article, we’ll analyze the recommendations of the scientific community regarding how to clean this area of the mouth and summarize them in 4 tips.

What is the interdental area?

In order to perform good interdental hygiene, it’s important to understand which area of the mouth we’re cleaning. The area between the gum and the point where the lateral walls of the teeth meet is called the interdental space.

In most people, there’s almost no separation between the teeth, and the proximal surfaces of the teeth come into contact with one another. When the space is this narrow, the entire area is occupied by a triangular-shaped portion of gum called the interdental papilla.

On the other hand, some people have separated teeth and the interdental space is more noticeable. In these cases, the dental papilla is less evident, as the gingival tissue undergoes a slight retraction.

As we’ll tell you later, in order to carry out good interdental hygiene, you must take into account the characteristics, shape, and size of these niches. The instruments and procedures to be performed will depend on the space between the teeth and the consistency of the gum.

The small space between teeth is inaccessible to the bristles of a conventional toothbrush. According to scientific literature, tooth brushing can only remove up to 60% of total plaque each time you clean. Therefore, if you only resort to traditional brushing to sanitize your mouth, you leave almost 40% of the teeth uncleaned.

Why perform good interdental hygiene?

If good interdental hygiene isn’t performed, food debris and bacteria accumulate in the spaces between teeth. Over time, mineral salts from saliva precipitate on this waste, giving rise to tartar or dental calculus.

Bacterial plaque and tartar are the causes of the most frequent oral diseases. Cavities and periodontal disease are the most common. These conditions not only affect the functions of the mouth, facial aesthetics, and the quality of life of those who suffer from them. In addition, it has been proven that they have a systemic impact and are associated with metabolic, cardiac, and neurological complications and adverse effects during pregnancy.

The regular removal of bacterial plaque helps to prevent the diseases and complications that derive from it. So, to maintain good oral health, it’s important to adopt certain cleaning practices and perform them frequently and properly. This includes good interdental hygiene that removes debris left between the teeth.

There are different auxiliary elements that complement tooth brushing and allow adequate interdental cleaning. Let’s see these tips that help keep the area between the teeth clean.

1. Floss for good interdental hygiene

Flossing is one of the simplest and most accessible techniques for good interdental hygiene. According to a non-experimental clinical study that analyzed the efficacy of dental floss as a complement to tooth brushing, passing a fine filament in each proximal space helps to break down and remove the bacterial plaque that accumulates there and improves gingival health.

In fact, it’s the only proximal hygiene element that can pass through very narrow spaces without crushing the interdental papillae. This makes it a convenient option for interdental hygiene in patients with crowded teeth.

To perform interdental cleaning, it’s important to cut a piece of dental floss that’s approximately 20 inches long and wrap its ends around each middle finger of both hands. Then, using back-and-forth movements and light pressure with the index finger and thumb, the thread is inserted into the space between the teeth, being careful not to injure the gum.

With the thread in the interdental area, press against the side of one of the teeth, forming a C. Movements are made from top to bottom for the upper teeth and from bottom to top for the lower teeth. Then the same action is repeated, pressing on the side of the other tooth in the same interdental space.

With clean thread, the cleaning of all the proximal spaces of the entire mouth continues. As we clean, unused silk is unrolled from one middle finger and the used silk is wrapped around the other middle finger.

Some people resort to a floss holder to make flossing easier. These are plastic instruments designed to hold the thread and have a handle that allows easy access to each interdental space.

Performing good interdental hygiene with silk requires perseverance and practice to improve dexterity. In fact, according to a cross-sectional study published by the Universidad Nacional del Nordeste, when surveying participants about oral health knowledge, attitudes, and habits, one of the greatest reasons for resistance to flossing is the skill required and the training needed to master the technique.

In addition, some respondents reported that laziness and lack of time prevented them from incorporating this type of cleaning into their oral hygiene routine.

2. Resort to interdental brushes

Interdental brushes are one of the most effective tools for practicing good interdental hygiene.

A study published by the American Academy of Periodontology compared the effectiveness of interproximal oral hygiene achieved with interdental brushes and dental floss. It was concluded that, although the differences are small, the use of interdental brushes is more effective in removing plaque bacteria and is better accepted by patients with periodontitis.

Interdental brushes have a plastic or metal handle and one end with bristles arranged in a cylindrical or conical spiral shape. They can be found in a wide variety of sizes, so that they can be adapted to the different dimensions of the interproximal spaces without damaging the gums.

They’re easy to use: The brush is inserted loosely into each interdental space so that the bristles—and not the wire—contact the side walls of the teeth. Movements are made from the inside out several times, without turning it, exerting a sweep on both proximal faces of the teeth. This is repeated in each interdental niche of the mouth.

Research indicates that they’re especially useful in patients with papillae that don’t fill the interdental space, who suffer from periodontitis, or who are users of orthodontic appliances, dental implants, and bridges.

3. Use an oral irrigator

Dental irrigators are devices that dispense a jet of water or other liquid under pressure. They’re used to clean different areas of the mouth, especially those that are difficult to access, such as the interdental spaces.

They consist of a water tank, a motor that drives the pump, and a mouthpiece that allows easy access to the mouth. The fine jet of pressurized water dispensed by the appliance is capable of gently dragging away food debris and unstructured debris present between the teeth.

Dental irrigators are safe and easy to use. They can be used in combination with some antiseptic solution or mouthwash to improve cleaning.

Dental irrigators are an auxiliary resource that complements and improve other oral hygiene techniques. Their use helps to achieve good interdental hygiene, especially in patients with dental implants, gum problems, or who use orthodontic appliances.

In addition, there’s evidence that its prolonged use increases gingival keratinization. This can have a beneficial effect on periodontal health, delaying the accumulation of plaque and tartar and reducing inflammation of the supporting tissues.

4. Visit the dentist frequently

Regular visits to the dentist are necessary to achieve good interdental hygiene. Frequent checkups and professional cleanings help keep the area between the teeth clean and healthy. It’s best to visit a professional once or twice a year.

When tartar is deposited between the teeth and under the gums, it’s only possible to remove it through dental prophylaxis performed by the dentist in the office. Through scraping with specific instruments, the use of ultrasound, and special pastes and brushes, all calculus deposits are removed until a clean and smooth dental surface is achieved.

Likewise, in dental consultations, the professional evaluates the individual needs of each person to advise them regarding the most convenient care to keep their interdental spaces clean and healthy. Scientific literature suggests that dentists should recommend to their patients the most appropriate products and techniques based on the size of their interproximal niches and their specific oral conditions.

Good interdental hygiene every day

To achieve good interdental hygiene, it’s crucial to reserve a time of day to perform oral cleaning. Cleaning the interproximal areas should be incorporated into the daily oral hygiene routine and practiced at least once a day.

After conventional toothbrushing, the interdental hygiene utensils that we’ll tell you about must be used. To finish cleaning, it’s important to rinse the mouth with an oral mouthwash.

In fact, a systematic review and meta-analysis that analyzed the efficacy of multi-ingredient mouth rinses in plaque control concluded that these products have antiplaque activity and are useful for maintaining good oral hygiene.

Performing good interdental hygiene requires predisposition, perseverance, and practice. Still, the health gain is worth the effort. Preventing cavities and periodontal disease, with all the discomforts and complications that these conditions produce, is motivation enough.