
Dr. Chandler Goltz of Slidell Smiles Gives Insight on Traditional Floss Versus Water Flossers
Both methods serve the same purpose—removing plaque and food debris from between the teeth and beneath the gumline—but they operate in fundamentally different ways. Traditional floss uses physical contact to scrape plaque away from tooth surfaces. Water flossers, on the other hand, use pulsating streams of water to flush out food particles and bacteria from interdental spaces and periodontal pockets.
The American Dental Association (ADA) has given its Seal of Acceptance to both tools when used correctly. However, the distinction lies in how each method affects gum health, particularly in individuals who are at higher risk for gingivitis or periodontal disease.
According to Dr. Chandler Goltz, DMD, owner of Slidell Smiles in Slidell, Louisiana, mechanical disruption of plaque is essential for preventing inflammation and infection in the gums. “Consistent plaque removal is one of the most critical steps in preventing gingival inflammation and supporting long-term periodontal stability,” Dr. Goltz said. “The method matters less than the result, which is clean interdental surfaces and minimal plaque retention.”
Studies comparing traditional floss and water flossers offer mixed results, largely depending on the population being studied. In individuals with excellent dexterity and existing healthy gums, string floss remains effective when used correctly. However, in patients with limited mobility, orthodontic appliances, implants, or crowns, water flossers often prove to be more practical and equally effective.
Clinical trials have demonstrated that water flossers can significantly reduce bleeding and gingival inflammation over time. One reason is the ability of water pressure to reach subgingival areas that floss may miss, particularly in deeper pockets or irregular spacing. The massaging action of the water stream also promotes improved circulation in the gums, which may support healing and tissue integrity.
String floss, while effective, requires precise technique to avoid damaging the gum tissue. Improper use—such as snapping the floss between teeth or not curving it around the tooth—can cause microtears in the gingiva, leading to irritation or recession. For many individuals, especially younger patients or those with dexterity challenges, this risk is not trivial.
On the other hand, water flossers eliminate the risk of flossing trauma but come with their own limitations. They may not effectively remove tightly adhered plaque or calculus. Additionally, they require access to water and power, making them less convenient in certain situations. Portability and cost can also be factors for consideration.
Both tools play a role in patient-specific hygiene routines. In clinical settings, personalized recommendations are often made based on gum health status, oral anatomy, and manual dexterity. Patients with periodontal concerns, braces, or implants are frequently advised to use water flossers in conjunction with brushing and antimicrobial rinses. For individuals with healthy tissue and good technique, string floss remains a viable standalone method.
Prevention of gum disease is ultimately tied to consistency, not just method. Daily interdental cleaning, regardless of the chosen tool, removes bacterial biofilm that can lead to inflammation and tissue breakdown. Professional cleanings and regular dental assessments complement these efforts and ensure that plaque control is effectively maintained over time.
Emerging technologies in water flossing continue to improve usability and clinical outcomes. Many newer models feature adjustable pressure settings, rotating tips, and antimicrobial reservoirs, making them adaptable for different oral care needs. Likewise, improvements in floss material—such as shred-resistant and comfort-coated options—have made traditional floss more accessible and easier to use properly.
Regulatory bodies and professional associations continue to emphasize that no single tool is universally superior. Rather, the focus is on proper technique, routine use, and early intervention when signs of gum disease appear. Bleeding gums, persistent bad breath, and gum sensitivity are all early indicators that interdental cleaning practices may need to be adjusted.
The decision between flossing and water flossing should ultimately be guided by clinical evidence and individual needs. In areas like southeastern Louisiana, where access to dental care varies and oral health disparities are common, equipping patients with effective, practical tools is part of broader preventive care strategies.
As awareness grows around the importance of gum health in relation to systemic conditions—such as diabetes, heart disease, and inflammatory disorders—the role of interdental cleaning continues to expand beyond cosmetic hygiene. Ensuring that patients understand their options and the proper usage of those options remains a primary objective for dental providers.
Morgan Thomas
Rhino Digital, LLC
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