Daily interdental plaque removal is crucial to augment the effects of toothbrushing because most dental and periodontal diseases originate in the interproximal areas.
Dahlen et al., found that 24 months after initiation of a supervised oral hygiene program, total viable count of bacteria in deep and shallow pockets such a Porphyromonas gingivalis and Aggregator actinomycetemcomitans decreased in number.
To help enhance the oral hygiene various interdental aids are used along with your toothbrush-
1. DENTAL FLOSS
It is a multifilament nylon yarn i.e, twisted / non twisted, bonded / non bonded, waxed / unwaxed.
Methods of flossing-
Spool technique (Finger - wrap method)
Cut 18-20" of floss and wrap each side of floss around each middle finger. Move the floss in between the teeth with index fingers and thumb in an up and down motion. Bend it to form a C on side of each tooth.
Loop technique (Circle method)
Cut 18" of floss and tie it in a circle. Place all the fingers except the thumb within the wrap. Use index finger to guide the floss through the lower teeth and thumb to guide it through the upper teeth.
Flossing tools are also available-
- Floss Holder / Pre-threaded flosser- For people with limited dexterity.
- Water flossers- Help clean area around braces or in areas where toothbrush can't reach .
- Powered flossing devices.
2. INTERDENTAL BRUSHES
They are cone-shaped or cylindrical brushes made up of bristles mounted on a small handle.
Types-
Unitufted Brush :
Used for furcation areas and lingual surfaces of mandibular molars and premolars, type-3 embrassures with complete loss of papillae.
Proxa Brush:
Used for concave interproximal surfaces and moderate papillary recession, type-2 embrasures.
Technique- They are inserted through interproximal spaces and moved back and forth between the teeth with short strokes.
3. WOODEN / RUBBER TIPS
Common devices readily available in households.
Wooden toothpicks are used either with handle or without handle. Access is easier from buccal surfaces for tips without handles, primarily in the anterior and bicuspid areas.
Triangular wooden tips are used for anterior areas.
Rubber tips and plastic tips are conical and mounted on handles or ends of a toothbrush. Both can be rinsed, reused and easily carried by a patient.
Technique-
Once mounted on a handle, toothpick is broken off so that its only 6-7mm long. The tip of a toothpick is used to trace along the gingival margin into the proximal areas from both the facial and lingual surfaces of each tooth.
The pick is then repeatedly moved in and out of the embrasure to remove food debris and plaque.
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