Brushing cleans the outer and inner surfaces of teeth, as well as the chewing surfaces; however, it is physically impossible for brush bristles to reach the interdental spaces where two teeth meet. A significant portion of plaque and food debris in your mouth accumulates in these areas. Dental floss is the only practical tool designed to clean these inaccessible surfaces. Since interdental spaces are often where tooth decay and gum disease begin, flossing is an essential part of oral hygiene.
Why can't a brush clean the interdental spaces?
You can think of a tooth as roughly a cube with five surfaces. A toothbrush can easily reach three surfaces of the tooth (the cheek side, the tongue side, and the top chewing surface). However, the two side surfaces facing the adjacent tooth are closed to the brush due to the point of contact between them. Bacterial plaque that accumulates in this area produces acid over time, decaying the enamel; and if this same plaque remains near the gums, it leads to inflammation, bleeding, and in the long term, gum recession.
Therefore, simply saying "I brush my teeth twice a day" only covers a portion of oral hygiene. When interdental spaces are not cleaned, approximately one-third of the tooth surface remains untouched. Dental floss closes this gap and controls the area where cavities and gum disease most frequently begin.
How to use dental floss step by step?
The correct technique makes the difference between flossing working and damaging the gums. The following steps are the basic method we demonstrate to our patients in the clinic:
- Cut a piece of string approximately 40-45 cm long. This will allow you to use a clean section for each tooth spacing.
- Secure the ends of the rope by wrapping them around the middle fingers of both hands several times. Check the working area with your thumb and index finger; leave approximately 2-3 cm of rope taut between your fingers.
- Insert the floss between your teeth using a sawing motion, that is, gently sliding it back and forth. Never press hard on the gums; sudden pressure will cut and injure the gums.
- When the string passes the point of contact, attach it to the side surface of a tooth. Letter C Wrap it like this. This "C wrap" technique ensures the floss follows the curve of the tooth, making full contact with the surface.
- Gently lower the floss into the gum line until you encounter noticeable resistance, and then scrape up and down the surface of the tooth 2-3 times.
- Repeat the process by wrapping the floss around the surface of the other tooth in the same space. Then, move to a clean section of floss and proceed to the next space.
It's important to use a fresh, clean section of floss for each gap between your teeth; otherwise, you'll transfer bacteria from one area to another. Don't skip the back surfaces of the furthest molars, as cavities often begin in this often overlooked area.
How often and when should it be used?
Using dental floss at least once a day is sufficient; the ideal time for this is at night. Saliva flow decreases during sleep, thus reducing the mouth's ability to clean itself. Cleaning the plaque that accumulates between the teeth during the day before bed prevents bacteria from producing acid throughout the night.
In most cases, the recommended order is flossing first, followed by brushing. Flossing loosens and removes plaque between the teeth, allowing subsequent brushing and fluoride toothpaste to reach those areas more effectively. However, the basic rule is: regardless of the order, flossing regularly once a day is far more valuable than occasional use of perfect technique.
Is bleeding normal?
Gum bleeding is common in the first few days and worries many people. This bleeding is usually not caused by flossing, but by existing inflammation (gingivitis) caused by plaque buildup between the teeth over time. Inflamed gums are prone to bleeding even with the slightest touch.
With regular and correct flossing, as plaque is removed from this area, gingivitis subsides, and bleeding usually decreases significantly or disappears completely within one to two weeks. So bleeding is mostly a sign to continue flossing, not to stop. However, if bleeding lasts longer than two weeks, increases, or is accompanied by significant swelling, pain, and bad breath, this requires professional evaluation. When we see this situation in our patients in the Kemerburgaz, Göktürk, or Sarıyer areas, we recommend an examination to rule out an underlying periodontal disease.
What is the difference between dental floss, interdental brushes, and oral irrigators?
There are multiple tools for interdental cleaning, and which one is suitable depends on the structure of your tooth gaps:
- Dental floss: It is the most suitable option for areas where teeth are in close contact and there are no visible gaps between them. Its thin structure allows it to reach below the point of contact.
- Interdental brush: It is more effective in cases of receding gums, widening gaps, or the presence of bridges, implants, and orthodontic wires. The appropriate thickness must be selected to fit the gap; the correct measurements are determined in the clinic.
- Oral douche (water jet): It removes debris with pressurized water and is particularly helpful around implants, bridges, or brackets. However, because it does not mechanically strip the plaque, it is not a replacement for floss or brushes; it is a complementary tool.
In most healthy mouths, flossing is the basic method. If you have receding gums, implants, or fixed prostheses, it's best to determine the most suitable combination together.
Common mistakes
People who don't see sufficient benefit from using dental floss often repeat the following mistakes:
- Pressing the floss firmly against the gums: Sudden and sharp pressure will cut the gums. The movement should always be gentle and saw-like.
- Simply inserting and removing the rope up and down: Simply passing the brush over the contact point without a C-shaped wrap will not clean the lateral surface of the tooth. The actual cleaning occurs through a scraping motion across the surface.
- Using the same section of string throughout the entire mouth: Contaminated thread carries bacteria from one area to another.
- Skipping the back teeth: Often neglected due to its difficulty in access, this area is one of the most at-risk locations for decay.
- Stop immediately when you see bleeding: In most cases, bleeding is a sign of inflammation that improves as the thread is continued.
- Irregular use: Cleaning once or twice a week will not prevent the maturation of the interproximal plaque. Daily consistency is what matters.
Flossing is a habit that takes some time and getting used to in the beginning, but within a few weeks it becomes a natural part of your routine. When done with the correct technique, it is one of the simplest and most effective investments you can make in lifelong dental and gum health.
Frequently Asked Questions
Should dental floss or toothbrush be used first?
In most cases, flossing first, then brushing is recommended; flossing loosens plaque in the interdental spaces, allowing subsequent brushing and fluoride to reach these areas better. Most importantly, it's about regular use once a day, regardless of your routine.
My teeth bleed when I use dental floss; is it harmful?
It is generally harmless. Bleeding is a sign of gingivitis caused by plaque buildup between the teeth and usually resolves within one to two weeks with regular use. If it lasts longer than two weeks or is accompanied by swelling and pain, a medical examination is recommended.
How many times a day should I use dental floss?
Using it at least once a day, preferably before bedtime, is sufficient. Since saliva flow decreases at night, cleaning before bed prevents bacteria from producing acid overnight.
Are interdental brushes or oral irrigators sufficient alternatives to dental floss?
It depends on the structure of your tooth spacing. For healthy teeth with close contact, flossing is the primary method; if you have gum recession, implants, or bridges, interdental brushing may be more effective. Oral irrigators, on the other hand, are not sufficient on their own because they do not mechanically remove plaque; they are complementary.
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