Your Healthy Teeth Toolkit – Consumer Reports

Why flossing matters:
Use any standard string floss (waxed or unwaxed), floss pick, or interdental cleaning brush. The scientific evidence for flossing is not as strong as it is for brushing: A 2019 Cochrane review found that flossing in addition to brushing may reduce plaque and gingivitis more than brushing alone, but the authors cautioned that the evidence supporting this conclusion was weak. Still, dentists say the biological justification for flossing is sound: Without it, the bacteria that cause decay would build up between your teeth even if you’re brushing regularly.

Do water flossers work?
While not quite as effective as string floss, water flossers can be a great option if you have a hard time using string floss, have mouth hardware like braces or a permanent retainer, or have other kinds of dental work like implants, bridges, or crowns. The ADA’s Sally Cram says the evidence on the benefits of a water flosser is encouraging, but it’s not enough for her to recommend it as a replacement for flossing just yet. Still, if you know you won’t use string floss every day, a water flosser is much better than nothing.

Avoid floss with PFAS.
Skip floss that’s coated with these environmental contaminants, which are associated with a variety of health problems. You can look for flosses that use non-PFAS coatings such as beeswax or plant waxes like carnauba or candelilla. You may also want to consider flosses made from natural fibers like silk or cotton instead of plastic.

How often to floss:
Do it once a day. Whether you floss or brush first doesn’t matter, as long as you do both.

What if you have implants or gum disease?
If you have an implant, you may want to opt for an interdental brush instead of regular string floss, particularly if your implant doesn’t touch the teeth next to it on either side.

These are tiny round brushes designed specifically to clean in between teeth, and they work well with teeth that have gaps in between them. They come in different sizes, so Jennifer Harmon, a registered dental hygienist and clinical associate professor at the University of North Carolina Adams School of Dentistry in Chapel Hill, recommends working with your dentist to figure out which size you need for your teeth.

If you’re dealing with bleeding gums, Arsenault says you can consider using prescription chlorhexidine mouthwash after you floss. Just be sure to follow your dentist’s instructions, because chlorhexidine can also cause some tooth staining and changes in taste.

PFAS-free floss options:
Some dental flosses are coated in PFAS (aka forever chemicals), which helps them slide easily between your teeth. But PFAS have also been linked to a number of health and environmental problems. Luckily, there are effective alternatives. CR partnered with Made Safe, an independent organization that certifies products as safer and more sustainable, to find flosses made without PFAS. Read our special report, “How to Choose Dental Floss Without PFAS and Other Harmful Chemicals,” for all the details, including three three good floss options made from silk instead of plastic.