It should not. If your gums are inflamed, they may bleed at first, but this should stop after a few days. Most units have pressure settings that you can work your way up from low to high pressure.
Water flossing is an oral hygiene method that uses a stream of water that pulsates to remove food particles and bacteria from the periodontal pockets. Recent medical literature supports that water flossing with a manual toothbrush is an effective oral care regimen for controlling gingivitis over four weeks [1] (Mancinelli-Lyle et al., 2023). Traditional floss remains superior for eliminating plaque from tight contact points between the teeth. For most patients, using both methods yields the best long-term periodontal care. Attempting to floss thoroughly while rushing can be difficult. However, skipping this step in oral hygiene increases the risk of dental issues and may result in more time spent in the dental chair than on the golf course at Shadow Glen. In this Enamel Dentistry Manor guide, our team breaks down how water flossing compares to traditional string floss.
According to studies, water flossing was found to be effective at reducing bleeding for patients with orthodontics [2] (AlMoharib HS et al., 2024). Research has shown that the pulsating water on the gum tissue increases blood flow and helps your body to fight inflammation. Water flossing is specifically effective for removing plaque; however, it requires the proper technique to match the ability of string floss.
Using a hybrid approach is best to get the most out of your oral hygiene routine. The plaque is easily removed by string floss, since it physically scrapes it away. Water flossers use high-pressure water to remove loose debris and flush deep into gum pockets. If you have tight contact points between teeth, string floss is considered the best option. Our team at Enamel Dentistry Manor recommends the hybrid method to use string floss to loosen debris, followed by the water flosser to flush the debris out.
Below is a table that compares the tools used for flossing.
Feature | String floss | Water flosser | Interdental brush |
Plaque removal | High | Moderate to high | High |
Gum health | Moderate | Superior | High |
Ease of use | Low | High | High |
Orthodontic use | Difficult | Superior | Moderate |
COst | Low | Higher up-front cost | Moderate |
Research has shown that pulsating water stimulates gum tissue, which can strengthen them over time. Water flossers are a great option for breath control, as they flush out bacteria responsible for halitosis (bad breath) that can hide deep in the periodontal pockets. If you have porcelain veneers, crowns, or other restorative dental work, string floss can sometimes shred or get snagged on the margins of the restorations. Water flossing is non-abrasive and safely cleans around the delicate titanium of implants without scratching, which prevents peri-implantitis.
If you have larger gaps between your teeth or periodontitis, an interdental brush can be beneficial. Interdental brushes fill the space by physically scrubbing the sides of the teeth where the traditional string might miss. Medical literature supports that interdental brushes are considered preferable to floss for interdental plaque removal in patients with moderate to severe periodontitis [3] (Christou et al., 1998). The anatomy of molars and premolars has concave surfaces on their medial and lateral sides. When string floss is taught, it spans across that hollow space. This causes the floss to completely miss plaque hiding inside the curve. The bristles of an interdental brush spring outward to fill the entire space and clean the concave surfaces that string floss glides over.
For braces, water flossing is very effective and efficient. Research shows that water flossing is 3 times as effective as string floss for removing plaque around orthodontic brackets. It removes food particles from the hardware, resulting in fewer dental complications. Here at Enamel Dentistry Manor, we strongly recommend our orthodontic patients invest in a cordless unit to keep them on hand to use after eating. If you are unsure if you are cleaning your braces effectively, ask our team for a demo on how to use a water flosser at your next cleaning.
It should not. If your gums are inflamed, they may bleed at first, but this should stop after a few days. Most units have pressure settings that you can work your way up from low to high pressure.
We recommend flossing before you brush. This dislodges the food and plaque, allowing the fluoride in toothpaste to coat the spaces between your teeth.
No. While water flossing is great for maintaining your teeth, it cannot remove hardened tartar. Once the plaque hardens, only professional dental instruments can remove it.
Dr. Ravin Chodavadia, DDS, provides comprehensive general and cosmetic dentistry at Enamel Dentistry in Austin, TX. He brings extensive experience in Invisalign, implant care, cosmetic treatments, and gum health. Known for his light-hearted, positive energy, he is committed to delivering thoughtful, evidence-based care that keeps patients comfortable and confident at every step.
[1] Mancinelli-Lyle, D., Qaqish, J. G., Goyal, C. R., & Schuller, R. (2023). Efficacy of water flossing on clinical parameters of inflammation and plaque: A four-week randomized controlled trial. American Dental Hygienists’ Association, 97(5), 166–186. https://jdh.adha.org/content/97/5/166
[2] AlMoharib HS, Alqasem A, Almusfer G, Aldosari MA, Almadhoon HW. The effectiveness of water jet flossing and interdental flossing for oral hygiene in orthodontic patients with fixed appliances: a randomized clinical trial. BMC Oral Health. 2024 Apr 27;24(1):498. doi: 10.1186/s12903-024-04166-0. PMID: 38678246; PMCID: PMC11055227.
[3] Christou V, Timmerman MF, Van der Velden U, Van der Weijden FA. Comparison of different approaches to interdental oral hygiene: interdental brushes versus dental floss. J Periodontol. 1998 Jul;69(7):759-64. doi: 10.1902/jop.1998.69.7.759. PMID: 9706852.
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