Practical option context-specific guidance inside a guide
Clean between your teeth in some form if you can do it consistently
- Evidence quality
- Best supported for plaque and gingival outcomes; broader prevention benefit is likely but less certain.
- Confidence
- medium-high
- Last reviewed
- 2026-05-30
Inside the larger guide
This option belongs to Is flossing necessary?
Read this page when you want one concrete route. Open the guide when you want the full answer, the main tradeoffs, and the reasoning across the whole decision.
Full guide Is flossing necessary? Evidence: moderateAction-oriented guidance
What this option means
Recommendation
A daily habit of cleaning between the teeth is reasonable for most people, but it does not have to mean string floss specifically.
Why this is reasonable
This helps because brushing alone does not reach the tight spaces where plaque accumulates. The evidence base suggests a modest but real benefit for plaque and gum-health outcomes, and the comparative literature shows that an interdental brush may be a better practical option for many mouths.
When it fits best
It fits especially well if you have tighter plaque-prone areas, early gum inflammation, braces, bridges, implants, recession, or a history of cavities between teeth. In those situations, the upside of interdental cleaning is more likely to matter.
Cautions and limits
If floss is hard to use well, forcing it may be less useful than switching tools. The goal is consistent interdental cleaning, not loyalty to one device.
Practical takeaway
Use this as a practical default, not as a rigid rule. If the situation changes or the option stops solving the real problem, adjust rather than forcing the recommendation beyond what the evidence supports.
Evidence behind this option
The reasoning this option depends on
Evidence check
Flossing or other interdental cleaning can reduce plaque and gingival inflammation beyond brushing alone
Bottom line
Cleaning between the teeth can help. The strongest sources in this set support a modest benefit for plaque control and gum inflammation when an interdental cleaner is added to brushing.
What seems true
The Cochrane review and the comparative review both point the same way: brushing alone misses some surfaces between teeth, and mechanical cleaning in those spaces can improve local plaque-related outcomes. That is the main reason flossing remains part of routine oral hygiene advice.
What is overstated or uncertain
What is less certain is how large that benefit is in everyday life and how much it translates into long-term outcomes such as cavity prevention, periodontitis prevention, or tooth retention. The evidence base is better for short-term bleeding or plaque measures than for years-long disease endpoints.
Practical meaning
For a low-risk person, this looks like a useful habit rather than a dramatic lifesaver. For someone with higher plaque-retention risk or a history of gum problems, the same modest average benefit may matter more because the baseline risk is higher.
Key sources for this judgment include Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries and An Overview of Different Interdental Cleaning Aids and Their Effectiveness.
That is enough to support a real practical judgment, but not enough to turn the claim into a universal rule for every reader or situation.
Evidence check
The evidence for flossing preventing cavities, tooth loss, or long-term periodontitis is weaker than the evidence for plaque or bleeding reduction
Bottom line
The evidence is much clearer for short-term plaque and gum-inflammation effects than for long-term outcomes like cavities, tooth loss, or periodontitis progression.
What seems true
The Cochrane review is the best source here, and its overall picture is that interdental cleaning probably helps some, but the literature is not strong enough to make a big claim about long-term disease prevention for everyone.
What is overstated or uncertain
Many studies are short, small, and focused on surrogate markers like bleeding or plaque scores. That means the research can show a biological effect without fully proving a large real-world benefit over years of use.
Practical meaning
This is why flossing advice can sound stronger than the evidence feels. The habit is reasonable and often worthwhile, but it is not supported by the kind of long-term trial evidence that would make it feel medically mandatory for every low-risk person.
Key sources for this judgment include Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries and Oral Health: Preventive Care.
That is enough to support a real practical judgment, but not enough to turn the claim into a universal rule for every reader or situation.
Evidence check
Interdental brushes are often a better fit than string floss for larger spaces and periodontal maintenance
Bottom line
String floss is not the only good way to clean between teeth, and it is often not the easiest or most effective one.
What seems true
The comparative review supports the practical point that interdental brushes can remove proximal plaque better than floss in some mouths, especially where there is enough room to use them or where someone is in periodontal maintenance. That is why many clinicians switch patients to brushes rather than insisting on floss at all costs.
What is overstated or uncertain
This does not mean brushes are always better for everyone. Tight contacts, crowded teeth, or certain restorations may still make floss the better fit. The best choice depends on anatomy, dexterity, and consistency.
Practical meaning
If string floss feels awkward or you never use it well, another interdental tool may give you better real-world results. The right tool is the one you can use correctly and often enough to matter.
Key sources for this judgment include An Overview of Different Interdental Cleaning Aids and Their Effectiveness and Flossing.
That is enough to support a real practical judgment, but not enough to turn the claim into a universal rule for every reader or situation.
Source support
Key sources behind this option
Source record
Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries
This source is used to support the main claim that interdental cleaning can add benefit beyond brushing, especially for plaque and gingival outcomes, and that the evidence is weaker for hard long-term endpoints. Do not use it to claim that every person must floss daily or that floss is always the best device for every mouth.
Source record
An Overview of Different Interdental Cleaning Aids and Their Effectiveness
This source is used to support the practical claim that floss is not always the best interdental tool and that interdental brushes may work better in larger spaces or periodontal maintenance settings. Do not use it to claim that floss is useless or that one device is universally superior in every mouth.
Source record
Flossing
This source is used to show that major dental organizations still recommend cleaning between teeth and view it as part of routine oral care. Do not use it as proof that flossing is mandatory for all people or that string floss is the best tool for every mouth.
Source record
Oral Health: Preventive Care
This source is used to support the broader point that oral health prevention depends on regular daily habits and that interdental cleaning is part of that system. Do not use it to claim that flossing alone prevents disease or that the CDC specifically proves one interdental tool is best.