In 2014, Delta Dental completed an oral health survey and found that 20% of Americans do not floss on a daily basis. This number is concerning because flossing helps people clean the harder to reach areas of the mouth that their toothbrush cannot reach–subgingival regions (below the gumline) and between teeth. Additionally, flossing helps protect the gums from inflammation and bleeding. If left untreated, poor gum health can result in periodontal disease which damages soft gum tissue and can even destroy bone structure.

In the last half century, dental manufacturers have introduced different methods of flossing to the dental field. One method being an oral irrigator (water flosser). 

US Dental Tribune. https://us.dental-tribune.com/clinical/study-waterpik-water-flossers-improve-oral-health-when-used-with-oscillating-electric-toothbrush/. accessed Feb 2021.

The first oral irrigator was invented by Joseph Marshall Parriot in 1962. Oral irrigators use pressurized water and pulsations to remove plaque between teeth and clean the gumline. Similar to string floss, for it to be effective, the user must floss all sides of the gums around the teeth as well as in between teeth. But, how does it stack up against string flossing?

Many studies have compared oral irrigators to string flossing as well as other flossing methods like air flossing and interdental brushes. For plaque removal, the results varied—some concluded that oral irrigators remove more plaque than other flossing methods, while others did not find a significant difference in plaque removal. Despite having inconclusive data on plaque removal, most studies concluded that oral irrigators reduce gingival (gum) bleeding better than other methods of flossing. This is good for reducing gingivitis (gum inflammation). Given these results, who can benefit from using oral irrigators over string floss? 

Two groups of people who can benefit are people with implants and people with. For people with implants, researchers found that oral irrigators reduce gingival bleeding better than string floss around implants. This is important to help maintain a clean implant, healthy gum tissue and solid bone structure surrounding the implant. For people with braces, string floss can clean teeth well, but it requires the aid of a floss threader to get underneath the wires. Threading floss between each tooth can become tedious and burdensome to the point that patients stop flossing as often. As a result, oral irrigators are a great substitute to make flossing easier and faster.

While researchers could not produce conclusive data on the relative effectiveness of oral irrigators on removing plaque in comparison to other flossing methods, they did find that it is a useful tool to reduce gingival bleeding and help maintain good oral hygiene between the teeth and along the gumline. Additionally, oral irrigators are not only limited to people who have implants or braces, but also for people who might not floss with string floss regularly due reasons like dexterity issues.

In general, the method of flossing comes down to personal preference. A notable potential drawback of using an oral irrigator over string floss is the price. A leader in the oral irrigator industry, Waterpik, prices their products as low as $40 and up to $140. In comparison, you can find string floss at your local drug store for just a few dollars. Nonetheless, whichever method you pick, flossing should remain a daily habit to maintain good oral hygiene and protect your oral health for the future.