Toothbrushing cannot clean the adjacent surfaces of teeth. If we want to remove the plaque accumulated on the adjacent tooth surfaces, we must use dental floss or interdental brush daily. Parents or caregivers can assist children or people in need to clean adjacent tooth surfaces by using a floss holder.

Photograph showing that abundant plaque is accumulated on the adjacent surfaces of upper and lower front teeth.
Plaque accumulated on the adjacent tooth surfaces

Flossing technique
Animation showing the use of thumbs and the forefingers of both hands to hold a portion of dental floss, leaving about 2 cm in between.

1.
Use a piece of dental floss which is approximately 20-25 cm long. Tie both ends to make a loop. Use the thumbs and the forefingers of both hands to hold the floss, leaving about 2 cm of floss in between.
Animation showing a sawing motion to pull the floss into the interdental space of lower teeth.

2.
Use a sawing motion to slide the floss into the interdental space.
Animation continued the previous motion that the floss is wrapped around a tooth making a “C” shape and is gently slid up and down against the tooth.  Then the floss is wrapped around another adjacent surface of the tooth to repeat the up and down motions.

3. Wrap around one tooth making a "C" shape and gently pull down to the deepest part of the gingival sulcus, and then slide it up and down against the tooth. Then wrap around the adjacent tooth and repeat the up and down motions.
 
4. Clean all the other adjacent tooth surfaces in the same way.

Points to note :

Please use a new part of floss every time as the used floss was contaminated with bacteria already.

Video display:Flossing Method
Method of using floss holder
Animation showing the floss portion of a floss holder being moved left and right between two teeth and slowly slid towards the gingival margin.

1. Move the floss holder left and right and slowly slide the floss towards the gingival margin. Pull the floss tightly against one of the adjacent tooth surfaces.
Animation continued from the previous motion showing the floss portion of the floss holder being wrapped around an adjacent tooth surface making a “C” shape in up and down motions.

2. Start from the deepest part of the gingival sulcus, gently slide the floss up and down to clean the adjacent tooth surface.
Animation continued from the previous motion showing the floss portion of the floss holder being wrapped around another adjacent tooth surface of the same tooth making a “C” shape.

3. Pull the floss tightly against the other adjacent tooth surface.
Animation continued from the previous motion showing the same floss portion moving up and downs for a few times.

 

4. Use the same technique, starting from the deepest part of the gingival sulcus, gently slide the floss up and down to clean the other adjacent tooth surface.
 
5. Clean all the other adjacent tooth surfaces in the same way.

Points to Note:

If there is a wide gap between the neighboring teeth, an interdental brush may be used instead of dental floss.

Solutions to common problems encountered when using dental floss
  • Difficult to control the dental floss
    The further the distance between the two fingers holding the floss, the more difficult it will be to control it. Therefore, you should keep the distance between the fingers to be about 2 cm and you can tighten up the floss when flossing. This will help improve the situation. You can start flossing on the front teeth, after mastering the skill, you can then try flossing on the posterior teeth.
  • Difficult to clean the posterior teeth
    To clean the adjacent tooth surfaces of posterior teeth, you will need to use the forefingers to control the floss inside the mouth.
  • Improper use of dental floss causes injury to the gingivae
    Correct use of dental floss will not cause any damage to the gingivae. You have to slowly “pull” the dental floss into the interdental space, pull the floss taut against one side of the adjacent tooth surfaces, start from the deepest part of the gingival sulcus, and slide the floss up and down to clean the surface. This will not injure the gingival tissue.
  • Difficulty in sliding the floss into the interdental space:
    This can be caused by the accumulation of calculus. The situation will be improved once the calculus has been removed by scaling. Remember to brush and floss your teeth daily after the calculus has been removed.
Method of using Interdental Brush
If the spaces between teeth are large like those teeth with gum recession due to gum disease, you may use interdental brush to clean the interdental space. Insert the interdental brush into the gap between the roots of the teeth, brush forward and backward to clean the adjacent tooth surfaces.
Animation showing the use of interdental brush to clean the adjacent tooth surfaces with wide gap.

Video display:Use of an interdental brush