Flossing Vs. WaterPik?

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RussianJoo

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what do you guys think is better at getting food that's stuck between your teeth out? I just switched and feel that the waterpik isn't doing a good enough job but then when i floss after using the waterpik there's nothing left between my teeth so i guess it is. Any study done on this? does anyone have any references?


also what's better to floss first and then brush or to brush first and then floss? any studies done on this?

thanks for your replies.

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My sister uses a waterpik but I still prefer regular floss. I just don't see how water can get under your gums.
 
So let's say you drop some food on the kitchen floor. What would be more effective at cleaning up the stain? Spraying it with a garden hose or wiping it with a sponge?
 
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So let's say you drop some food on the kitchen floor. What would be more effective at cleaning up the stain? Spraying it with a garden hose or wiping it with a sponge?


except floss isn't a sponge, it doesn't soak anything up. the analogy that fits this better is what would you use to clean up graffiti off a concrete wall? you can either sit there and scrub the area with a brush or use a pressure washer hose to clean it off. If you could get between your teeth with a toothbrush there would be no need for flossing.

So I guess there are no studies done on this?

ok thanks for your help everyone.
 
I use both waterpik and floss. It works great cuz there are some areas that floss can't get to and there are some areas that waterpik can't get to. It's very simple. Just because u add one thing to help protect ur gum, it doesn't mean u have to stop flossing (although thats what they ad as). I believe that waterpik help u from perio regardless.
 
except floss isn't a sponge, it doesn't soak anything up. the analogy that fits this better is what would you use to clean up graffiti off a concrete wall? you can either sit there and scrub the area with a brush or use a pressure washer hose to clean it off. If you could get between your teeth with a toothbrush there would be no need for flossing.

So I guess there are no studies done on this?

ok thanks for your help everyone.

I could find 2 citations regarding usage of a waterpik vs. manual floss. The latest,Barnes CM et al. J Clin Dent 2005; 16(3); 71-77, showed a significant difference in the plaque accumulation of manual flossing vs. waterpik'ing, but only evaluated the facial and ligual surfaces of teeth. This is a huge defect in the study, considering the reason to floss is removal of interdental plaque.

The second citation, Shibly et. al. J Clin Dent 2001;12:63-66, showed no significant difference between flossing and waterpik'ing, but I don't have access to the article at the moment to see if their methodology is flawed enough to effectively ignore.

Take home message, waterpik is certainly better than nothing at all, but I doubt you're getting as effective interdental plaque removal as you get with manual flossing. I think it's an awesome product for populations for whom flossing is very difficult (orthodontics, lots of bridgework), or possibly for delivering periodontal chemotherapeutics.
 
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except floss isn't a sponge, it doesn't soak anything up. the analogy that fits this better is what would you use to clean up graffiti off a concrete wall? you can either sit there and scrub the area with a brush or use a pressure washer hose to clean it off. If you could get between your teeth with a toothbrush there would be no need for flossing.

I have a feeling the analogies are going to flow strong in this thread. :D
 
I use both and think they are complementary in what they accomplish best.

My thinking of what each teeth cleaning component does best is:

Brushing removes 'stuff' from buccal/lingual/occlusal surfaces of teeth and cleans gums.
Flossing removes 'stuff' from interproximal surfaces of teeth and under gums.
Waterpik flushes 'stuff' from under the gums.
And rinse is like having a party in your mouth...unless you use listerine.

I don't think any one component is a 'cure all.'
 
I could find 2 citations regarding usage of a waterpik vs. manual floss. The latest,Barnes CM et al. J Clin Dent 2005; 16(3); 71-77, showed a significant difference in the plaque accumulation of manual flossing vs. waterpik'ing, but only evaluated the facial and ligual surfaces of teeth. This is a huge defect in the study, considering the reason to floss is removal of interdental plaque.

The second citation, Shibly et. al. J Clin Dent 2001;12:63-66, showed no significant difference between flossing and waterpik'ing, but I don't have access to the article at the moment to see if their methodology is flawed enough to effectively ignore.

Take home message, waterpik is certainly better than nothing at all, but I doubt you're getting as effective interdental plaque removal as you get with manual flossing. I think it's an awesome product for populations for whom flossing is very difficult (orthodontics, lots of bridgework), or possibly for delivering periodontal chemotherapeutics.

Thank you very much for your post.

Do you have any comments or come across any research of regular floss vs. plackers? I personally have pain in my fingers from the wrapped floss around them so using a placker was more convenient but is it as affective?
PlackersSingles.jpg
 
Thank you very much for your post.

Do you have any comments or come across any research of regular floss vs. plackers? I personally have pain in my fingers from the wrapped floss around them so using a placker was more convenient but is it as affective?

I haven't seen any research on that subject, but I have recommended them to some patients who have manual dexterity issues and they seem to be working well. Just make sure you use the flosser to clean each tooth adjacent to the area you're flossing.
 
I use both and think they are complementary in what they accomplish best.

My thinking of what each teeth cleaning component does best is:

Brushing removes 'stuff' from buccal/lingual/occlusal surfaces of teeth and cleans gums.
Flossing removes 'stuff' from interproximal surfaces of teeth and under gums.
Waterpik flushes 'stuff' from under the gums.
And rinse is like having a party in your mouth...unless you use listerine.

I don't think any one component is a 'cure all.'

wow you must spend like 30min a day doing all that.

Do you mind sharing what order you do that in?

here's my routine... Wash my hands, then do the waterpik go over each tooth surface twice from the front and once from the back. then brush for about 3min, then rinse with listerine. This is at night.. in the morning i am lazy and just brush my teeth for about 3min. I like the listerine (no pain no gain right?).
 
I haven't seen any research on that subject, but I have recommended them to some patients who have manual dexterity issues and they seem to be working well. Just make sure you use the flosser to clean each tooth adjacent to the area you're flossing.


What's about adding a few ml's of hydrogen peroxide to the water that you use in the waterpik. a dentist told me to be careful with that cause it might actually stain my teeth in the long run, do you mind quickly going over the pathophysiology of that?
 
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and the whole flossing before or after brushing? I guess it really doesn't matter when you do it as long as you do it?

my theory is that flossing brings out junk from between your teeth and moves it to another part of your teeth that can now be reached with a toothbrush or another part of your mouth. thus I floss first, then rinse with water, and then brush. (when I did floss, now i just waterpik)
 
And just wanted to say thanks in advance guys for your posts and comments. Greatly appreciated.
 
I like the flossers (plackers?). They're easier to use than regular floss, and anything that makes flossing easier means more patients will actually do it instead of lying to the hygienist every six months that "I floss four times a day every day."
 
What's about adding a few ml's of hydrogen peroxide to the water that you use in the waterpik. a dentist told me to be careful with that cause it might actually stain my teeth in the long run, do you mind quickly going over the pathophysiology of that?

I'm not sure how hydrogen peroxide would "stain" your teeth, I could potentially see you selectively whitening only parts of your teeth though, giving them a mottled appearance. Peroxides are the active ingredient in whitening formulations, and basically oxidatively degenerate organic chromophores that discolor the tooth.

If I were you, I'd stick to using the thing as directed by the product insert/dentist instructions.
 
wow you must spend like 30min a day doing all that.

Do you mind sharing what order you do that in?

here's my routine... Wash my hands, then do the waterpik go over each tooth surface twice from the front and once from the back. then brush for about 3min, then rinse with listerine. This is at night.. in the morning i am lazy and just brush my teeth for about 3min. I like the listerine (no pain no gain right?).
Oops, I should have added the disclaimer that this example was only for discussion and in no way representative of reality.

The reality is that I brush 2-4 times a day, but only floss 2-3 times a week and waterpik 2-3 times a week.
We seem to follow the same routine with the waterpik. I linger on any sore spots. I fill up the container and pik until it is empty. Then I brush for ~3 minutes going over all tooth, gum surfaces thoroughly, then a quick brush of my cheeks, tongue, and palate. I only pik/floss at night and don't usually do both at the same session. I don't have a rinse either, I just threw that in as a funny. I guess it wasn't.
 
Oops, I should have added the disclaimer that this example was only for discussion and in no way representative of reality.

The reality is that I brush 2-4 times a day, but only floss 2-3 times a week and waterpik 2-3 times a week.
We seem to follow the same routine with the waterpik. I linger on any sore spots. I fill up the container and pik until it is empty. Then I brush for ~3 minutes going over all tooth, gum surfaces thoroughly, then a quick brush of my cheeks, tongue, and palate. I only pik/floss at night and don't usually do both at the same session. I don't have a rinse either, I just threw that in as a funny. I guess it wasn't.

oh sorry.. yeah i mean i think it's like a party in my mouth.. especially with the high alcohol content of some mouthwashes.

but proper dental hygiene is not a joking matter! :)laugh:)
 
As far as I'm concerned, waterpick is NOT for healthy young adults with intact interproximal papillae. Waterpick is for an older crowd of patients, with chronic periodontitis and enough attachment loss/recession causing partial or total loss of the inter dental papilla (IDP). Then and only then can you make an argument for the waterpick. It's the same concept as an interproximal brush. You would not jam that into healthy gingival tissue, now would you ?

If you have your IDP (and would like to keep them) floss, floss, floss.
 
and the whole flossing before or after brushing? I guess it really doesn't matter when you do it as long as you do it?

my theory is that flossing brings out junk from between your teeth and moves it to another part of your teeth that can now be reached with a toothbrush or another part of your mouth. thus I floss first, then rinse with water, and then brush. (when I did floss, now i just waterpik)

my gf's dentist told her to floss AFTER you brush b/c you could brush the bacteria into the cuts you create when you floss.

i initially did it the way you described b/c of the same reasoning but i've switched now.
 
my gf's dentist told her to floss AFTER you brush b/c you could brush the bacteria into the cuts you create when you floss.

i initially did it the way you described b/c of the same reasoning but i've switched now.


thanks, yeah i guess that would make a little more sense. but how often do you get cuts now? I mean my gums haven't bled in years. or do your gums get cut without necessarily bleeding?
 
my gf's dentist told her to floss AFTER you brush b/c you could brush the bacteria into the cuts you create when you floss.

i initially did it the way you described b/c of the same reasoning but i've switched now.
Bacteria get into your bloodstream from your mouth routinely. Anytime you produce bleeding inside your oral cavity, bacteria migrate into the bloodstream. It's no big deal, because in an immunocompetent person, they're all dead within minutes. The sequencing of your oral hygiene routine isn't a life-or-death issue.
 
NileBDS said:
As far as I'm concerned, waterpick is NOT for healthy young adults with intact interproximal papillae. Waterpick is for an older crowd of patients, with chronic periodontitis and enough attachment loss/recession causing partial or total loss of the inter dental papilla (IDP). Then and only then can you make an argument for the waterpick. It's the same concept as an interproximal brush. You would not jam that into healthy gingival tissue, now would you ?

If you have your IDP (and would like to keep them) floss, floss, floss.
I don't know about Harvard, but at my cut-rate second-class state dental school they taught me that advanced chronic periodontitis isn't the only possible mechanism by which food can impact between teeth below the proximal contacts. ;)
 
Bacteria get into your bloodstream from your mouth routinely. Anytime you produce bleeding inside your oral cavity, bacteria migrate into the bloodstream. It's no big deal, because in an immunocompetent person, they're all dead within minutes. The sequencing of your oral hygiene routine isn't a life-or-death issue.

So someone with an autoimmune disease should not floss?
 
That's not what I said. Having an autoimmune disorder does not equal being immunocompromised.

Regardless, you didn't answer my question. Should someone with an autoimmune disease not floss?
 
Regardless, you didn't answer my question. Should someone with an autoimmune disease not floss?

why not? what does autoimmune have to do with that. You're probably confusing the term autoimmune (your body makes antibodies against it's self) with immunodeficiency or immunocomprimised (your body lacks a proficient immune system to fight off infections).

Autoimmune people actually have a hyperactive immune system, not a deficient one.
 
why not? what does autoimmune have to do with that. You're probably confusing the term autoimmune (your body makes antibodies against it's self) with immunodeficiency or immunocomprimised (your body lacks a proficient immune system to fight off infections).

Autoimmune people actually have a hyperactive immune system, not a deficient one.

Yeah, my bad. I'm not a dental student/medical student/resident so I don't know these terms exactly ;). You're right, what I meant to ask was immunodeficiency or immunocomprimised.
 
I would suggest the Waterpik for those with perio pockets, NOT those with interdental plaque alone. Floss > Waterpik for interdental plaque, IMO.

As for the Plackers.. if it is the difference between flossing and not flossing, then by all means use the device. Otherwise, use regular floss as it allows you to hug the adjacent teeth to remove plaque that is often left when brushing.

Hup
 
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As most of you know BOP is highly indicative of perio dz. Out of curiosity, I bought the waterpik and used it after brushing before bed time for 1 month without conventional floss. Then after one month, brushed the teeth and flossed-> no BOP. Healthy looking gingiva!

On the negative side, that jet of water does not go through contacts, thus might not prevent formation of interporximal lesions. Wonder if there is any research on it... im too lazy to look for it right now.
 
As most of you know BOP is highly indicative of perio dz. Out of curiosity, I bought the waterpik and used it after brushing before bed time for 1 month without conventional floss. Then after one month, brushed the teeth and flossed-> no BOP. Healthy looking gingiva!

On the negative side, that jet of water does not go through contacts, thus might not prevent formation of interporximal lesions. Wonder if there is any research on it... im too lazy to look for it right now.

so for the none dental folk, does that mean the waterpik gets the job done as effectively as flossing?
 
so for the none dental folk, does that mean the waterpik gets the job done as effectively as flossing?


Tough question :) Since I didn't see BOP (bleeding) after a month of using it, then yes... at lease in my case. Looks like it is effective in preventing gum disease. But not sure if it's effective against cavities (caries) between the teeth. It is a multi factorial process as far as developing cavities and so is gum disease. But on the other hand, it takes just about the same time to use that WaterPik as it would with a floss if done properly of course.

WaterPik would definitely be a good adjunct to those people that already have active gum disease.

Hope that helps :)
 
hmm, I've always thought that flossing before brushing was done in that sequence because I figured that when we're flossing, we're just pushing food into places where the brush is accessible (like some other poster mentioned above). Is this reasoning wrong?
 
You're not flossing simply to remove food from between your teeth. You're flossing to disrupt the biofilm of bacteria that's formed in the areas inaccessible to your brush.
 
Hey, this is my first post here. I'm searching for the answer to why some people think flossing is important, while me and all my friends who are about my age (24) do not floss, and seem none the worse for wear. Following is a rather long-winded explanation of the view I hold of flossing and questions of the WaterPik (hence why it is this forum) are in there as well. If this is too long-winded just delete it and I'll try again with less rambling... anyways, no offense is meant against any individual.

Someone poster in another site: "I can't shake the feeling that flossing is for saps", and neither can I. I've rarely floss, and pretty much only do so if I have something stuck in there that's annoying me.
This latest time I went to the dentist, one the dental hygienists (yes, the your-suggested-tooth-cleaning-scheme-seems-insane-to-everyone-but-other-dental-hygienists) types) said I have gingivitis. Now, they say its not from flossing, but I think that since I've never had it before, or any cavities for a very long time (many years), and the only thing I did different tooth-maintenance-wise since last visit was drink large amounts of Gaviscon right before bed (after brushing)... so, personally I think this is the cause, since I never had the problem until I deviated from my regular maintenance system (I thought, "oh, its medicine, no harm there... but in retrospect that seems to be an unfounded assumption). Now, I was a bit worried (which I now regret, as it seems that I can never get a good reason for flossing from anyone other than it'll let you keep your teeth and not get cavities, and I haven't lost my teeth nor have I gotten cavities, thus all data from the dentist-office-types will be held as suspect until I hunt down unbiased research and interpret it for myself), so I thought: "a world of flossing everyday... I'd rather lose my teeth... die 5 years earlier... anything but flossing... so I bought this "WaterPik" thing since I loathe flossing (I can't get the floss to go in between without using quite a lot of force, which then tends to make me cut into my gums once it finally gets through them)... Anyways, the website said it should replace flossing, so I thought it was alright. Now, I don't just trust the manufacturer's word that their product is teh win, so I sent a request for data to the CDA as they encourage people to do on their website (to which I got no response), and my dentist said it was less important then flossing.

Again, sorry (but not very) if you're offended by this, but it really is my view. So is my signature. And I know some who agree with me. So, I thought I'd ask some fellow students for their opinion, hopefully someone will have an answer other than the stereotypical dentist-office malarkey of preventing cavities (which I don't usually get anyways) and keeping your teeth (we DO have orthodontics in the year 2009, and if they're not that good then we humans can always build a better one! With lasers! And automatic whipped-cream dispensers! And automatic anti-floss cannons!)

By Numidium, I hope I don't get kicked from here before I get an answer...
 
Hey, this is my first post here. I'm searching for the answer to why some people think flossing is important, while me and all my friends who are about my age (24) do not floss, and seem none the worse for wear. Following is a rather long-winded explanation of the view I hold of flossing and questions of the WaterPik (hence why it is this forum) are in there as well. If this is too long-winded just delete it and I'll try again with less rambling... anyways, no offense is meant against any individual.

Someone poster in another site: "I can't shake the feeling that flossing is for saps", and neither can I. I've rarely floss, and pretty much only do so if I have something stuck in there that's annoying me.
This latest time I went to the dentist, one the dental hygienists (yes, the your-suggested-tooth-cleaning-scheme-seems-insane-to-everyone-but-other-dental-hygienists) types) said I have gingivitis. Now, they say its not from flossing, but I think that since I've never had it before, or any cavities for a very long time (many years), and the only thing I did different tooth-maintenance-wise since last visit was drink large amounts of Gaviscon right before bed (after brushing)... so, personally I think this is the cause, since I never had the problem until I deviated from my regular maintenance system (I thought, "oh, its medicine, no harm there... but in retrospect that seems to be an unfounded assumption). Now, I was a bit worried (which I now regret, as it seems that I can never get a good reason for flossing from anyone other than it'll let you keep your teeth and not get cavities, and I haven't lost my teeth nor have I gotten cavities, thus all data from the dentist-office-types will be held as suspect until I hunt down unbiased research and interpret it for myself), so I thought: "a world of flossing everyday... I'd rather lose my teeth... die 5 years earlier... anything but flossing... so I bought this "WaterPik" thing since I loathe flossing (I can't get the floss to go in between without using quite a lot of force, which then tends to make me cut into my gums once it finally gets through them)... Anyways, the website said it should replace flossing, so I thought it was alright. Now, I don't just trust the manufacturer's word that their product is teh win, so I sent a request for data to the CDA as they encourage people to do on their website (to which I got no response), and my dentist said it was less important then flossing.

Again, sorry (but not very) if you're offended by this, but it really is my view. So is my signature. And I know some who agree with me. So, I thought I'd ask some fellow students for their opinion, hopefully someone will have an answer other than the stereotypical dentist-office malarkey of preventing cavities (which I don't usually get anyways) and keeping your teeth (we DO have orthodontics in the year 2009, and if they're not that good then we humans can always build a better one! With lasers! And automatic whipped-cream dispensers! And automatic anti-floss cannons!)

By Numidium, I hope I don't get kicked from here before I get an answer...
I welcome people with your view. They keep my hygienists (and, by extension, me) busy and well-paid. :)
 
I also hate flossing. I have to apply a lot of force to get the string in between my teeth and because i use a lot of force the string cuts my fingers. Also the string breaks sometimes which really pisses me off. I am seriously considering getting the WaterPik.
 
I will admit flossing is tedious but it's important to keep your mouth/gums healthy. I have a bonded retainer in my mouth so it's extra annoying to floss so I use something called superfloss. It has a stiff part on one end that lets you thread it through the spaces of your teeth to get right in there, so I can't see why it wouldn't work if you have super tight contacts. Try it so that you're not frustrated trying to force it through, just go between.
 
I found a study that is, among its many proper research study practices, examiner-blind. This study supports the WaterPik as being better than floss at:
Gingivitis/facial, Gingivitis/lingual, Bleeding/facial, Bleeding/lingual, Plaque/facial, and Plaque/lingual.
For Gingivitis/lingual it seems that a powered toothbrush is inferior to manual toothbrush such much so that even with using the WaterPik, a power toothbrush is not as good as a manual toothbrush and floss; however, a manual toothbrush and WaterPik is superior to a manual toothbrush and floss.


And a single-person study with absolutely no rigor what-so-ever finds that the WaterPik is far more pleasant than flossing :D



In addition to this study that indicates that WaterPik is superior to flossing, there is also the anecdote that many, MANY people dislike flossing (this is my experience, hence an anecdote, not a fact, and I know some people who floss regularly) to the point of not flossing regularly. Perhaps many of these people would rather use the WaterPik. Personally, I find that I can use the WaterPik every night (at max pressure) and it doesn't bother me (I love gadgets, and this certainly qualifies for one that I can use for the rest of my life). In fact, it's kinda fun. As soon as I find out whether or not mouthwash is good for teeth, I might even start using that to WaterPik with!

Perhaps the difference in this study and any studies which say that the WaterPik is inferior to flossing is the instructions given in how to use the WaterPik, or, maybe the pressure (this study only used medium pressure).

http://www.dentist.net/waterpik-article.asp


:soexcited: I don't ahve to flo-oss, I don't have to flo-oss! :banana:
 
As most of you know BOP is highly indicative of perio dz. Out of curiosity, I bought the waterpik and used it after brushing before bed time for 1 month without conventional floss. Then after one month, brushed the teeth and flossed-> no BOP. Healthy looking gingiva!
On the negative side, that jet of water does not go through contacts, thus might not prevent formation of interporximal lesions. Wonder if there is any research on it... im too lazy to look for it right now.


I have braces and I hate them. They hurt and crap is ALWAYS getting stuck in them. Flossing with brackets is a nightmare. When I get a new wire and I get to floss like it was the good ol' times, I want to cry at how carefree and easy it is. I want to break out in song and dance up and down the orthodontic clinic isle, skipping and jumping at how easy it is to floss. I swear that I will never take flossing for granted again.

I am fairly conscientous about my oral hygiene and after I got braces, I rarely flossed. I hate to admit it, but it is the truth. After a month or so, I picked up a waterpick. Love it. I still floss the contact areas, but that is it, and at my last visit, no bleeding on flossing anywhere. SO, if you have a patient who is not going to floss, or is in braces I would strongly recommend the waterpick. I know that my orthodontist recomends them to all his patients.

I think its legit and would recommend it without reservation.
 
I found a study that is, among its many proper research study practices, examiner-blind. This study supports the WaterPik as being better than floss at:
Gingivitis/facial, Gingivitis/lingual, Bleeding/facial, Bleeding/lingual, Plaque/facial, and Plaque/lingual.
For Gingivitis/lingual it seems that a powered toothbrush is inferior to manual toothbrush such much so that even with using the WaterPik, a power toothbrush is not as good as a manual toothbrush and floss; however, a manual toothbrush and WaterPik is superior to a manual toothbrush and floss.


And a single-person study with absolutely no rigor what-so-ever finds that the WaterPik is far more pleasant than flossing :D



In addition to this study that indicates that WaterPik is superior to flossing, there is also the anecdote that many, MANY people dislike flossing (this is my experience, hence an anecdote, not a fact, and I know some people who floss regularly) to the point of not flossing regularly. Perhaps many of these people would rather use the WaterPik. Personally, I find that I can use the WaterPik every night (at max pressure) and it doesn't bother me (I love gadgets, and this certainly qualifies for one that I can use for the rest of my life). In fact, it's kinda fun. As soon as I find out whether or not mouthwash is good for teeth, I might even start using that to WaterPik with!

Perhaps the difference in this study and any studies which say that the WaterPik is inferior to flossing is the instructions given in how to use the WaterPik, or, maybe the pressure (this study only used medium pressure).

http://www.dentist.net/waterpik-article.asp


:soexcited: I don't ahve to flo-oss, I don't have to flo-oss! :banana:
what about interproximal, ya know, where floss goes.
 
Actually, I don't know. What is interproximal? Why does it need flossing/any attention at all? Getting this information out of any dentist is usually rather difficult. It's like they think modern young people don't want to know this stuff. I am a student, but of mechanical engineering, so words like "interproximal" do not have significant meaning besides maybe picking apart their etymology. My searching online has been mostly fruitless except for that study and this forum, else I would just lookup interproximal myself. Is interproximal that area where the teeth contact each other at the top of the molars/premolars/whatever-the-hell-they're-called? Thanks for the word "interproximal"! It is a clue in this mystery of why dentists want us to floss... or is it the dental hygienists who want us to floss?
 
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