Brushing cleans the outer, inner, and chewing surfaces of your teeth, but it misses nearly 40% of tooth surfaces—specifically the tight spaces between teeth (interproximal areas) and under the gumline.

To clean these hidden areas, interdental cleaning is essential. The two most popular methods are traditional string floss and water flossers (such as a Waterpik). While both tools aim to keep your gums healthy, they work using entirely different physical mechanisms.

Understanding the differences helps you choose the right interdental cleaner—or combine both for optimal periodontal protection.

Cleaning between your teeth

It is recommended you brush your teeth twice a day and clean between your teeth at least once a day. Poor oral hygiene can cause cavities, bad breath, tooth loss, and gum disease. Brushing your teeth is a great place to start improving your oral health. Just brushing, alone, is not enough. Those pesky food particles, plaque, and bacteria that hide between your teeth need attention too. The bristles of your toothbrush are not small enough to clean effectively in those tight spaces. To reach these areas, some sort of interdental cleaning is recommended. What tools for cleaning between your teeth are best for you? Your hygienist or dentist can help make suggestions for your specific needs. Two main tools include dental floss and the Waterpik. Which one is better? Should you use both?

The Mechanical Difference: Friction vs. Hydraulic Pressure

Feature	Traditional String Floss	Water Flosser (Waterpik)
Cleaning Mechanism	Direct physical friction (scraping)	Pulsating hydraulic pressure & fluid dynamics
Primary Strength	Wipes sticky, adherent biofilm off tooth walls	Flushes unattached bacteria & debris from deep pockets
Subgingival Penetration	1–3 mm beneath the gumline	Up to 6 mm with periodontal pocket tips
Gingival Inflammation Reduction	Moderate	Superior at reducing bleeding and gingivitis index
Ease of Use	Requires manual dexterity & correct technique	High user compliance; ideal for braces/implants
Cost & Portability	Extremely low cost; highly portable	Higher upfront cost; requires power/water source

Waterpik (Water-Flosser)

ARE WATERPIKS GOOD FOR TEETH AND GUMS?

The Waterpik, or water-flosser, is a tool that can be used to keep your teeth and gums healthy and clean. It uses a pressurized stream of pulsating water to clean away the food particles, bacteria, and plaque between your teeth and under your gums. The American Dental Association says water-flossers, with the ADA seal of acceptance, can get rid of plaque. This plaque can lead to cavities and gum disease if not removed. The Waterpik water-flosser is more effective for people with braces, bridges, crowns, or dental implants.

Pros:

It is easy to use. Because of the design of the handle, it can be easier to use for people with arthritis, or anyone who finds string floss difficult to maneuver.
It gets into the hard-to-reach areas. These areas include tightly spaced teeth and periodontal pockets caused by gum disease.
The Waterpik water-flosser can prevent bleeding in the gums

Cons:

It may not remove all plaque. The Waterpik may not be enough to remove all the plaque from the surface of the teeth.
They cost more than string floss. A Waterpik can range in price from $35-100.
They can be messy and take time to get used to. A tip for best results: place the tip in your mouth before turning it on, glide the tip along the gumline gently, starting in the back and working forward. Make sure to clean both the inside and outside of both the upper and lower teeth.

Dental Floss

The good-old string floss! Dental floss was first recommended by a dentist named Levi Spear Parmly in 1819. It was traditionally made from unwaxed silk and gained popularity after World War II when it was replaced with nylon. Floss now comes in a variety of flavors, waxed, and unwaxed strands. Everyone should floss as it is an essential part of dental hygiene.

Pros:

It is easy to control.
Flossing allows you to wipe down each tooth and maneuver the floss between teeth.
It removes bacteria, plaque, and food particles from between your teeth.
It allows you to wipe each tooth clean of the sticky plaque before it can turn to tarter.

Cons:

It can be difficult to reach some areas. Teeth that are close together can be difficult to floss. -People with arthritis or dexterity issues, may have a difficult time controlling the floss.
Aggressive flossing can cause bleeding. If you floss too far below the gumline or too forcefully, your gums may bleed.

Flossing can be done before or after brushing. The American Dental Association states that either way is acceptable as long as you do it. A recent study published in the Journal of Periodontology, showed that the amount of plaque between the teeth was reduced more from the floss first, brush second method.

What Does Clinical Research Say?

Research published in the Journal of Clinical Dentistry and the Journal of Periodontology reveals clear insights regarding efficiency:

For Bleeding and Inflammation: Water flossers consistently outperform string floss at reducing gingival bleeding and gingivitis indexes across clinical trials.
For Plaque Index: Both tools significantly reduce interproximal plaque when used correctly. String floss excels at mechanical plaque removal at the contact point, while water flossers excel at flushing subgingival plaque mass.
For Patients with Periodontitis: Water flossers provide superior delivery of water (or antimicrobial rinses) into deep periodontal pockets where traditional floss cannot reach.

Which Should You Use?

The choice depends on your specific oral health profile:

Choose String Floss If:

You have tight tooth contact points with healthy gum tissue (pocket depths under 3 mm).
You want a low-cost, portable interdental cleaning solution.
You have full manual dexterity to practice proper “C-shape” flossing technique.

Choose a Water Flosser If:

You have periodontal disease, bleeding gums, or deep pockets (4 mm or deeper).
You have dental implants, crowns, bridges, or braces.
You experience chronic dry mouth or struggle with manual dexterity due to arthritis.
You find string floss painful, difficult, or unappealing (leading to skipped routines).

The Best Approach: Use Both

For optimal periodontal maintenance—especially if you have a history of periodontitis—combining both tools provides the highest level of care:

Use string floss first to break contact point tension and physically scrape adherent biofilm from tooth surfaces.
Follow with a water flosser to flush out the loosened plaque, debris, and subgingival bacteria from below the gumline.

Specialized Periodontal Care in Tigard, OR

Whether you rely on string floss, a water flosser, or a combination of both, routine home care must be paired with professional periodontal evaluation to keep your teeth and jawbone healthy.

At Progressive Periodontics, our team provides comprehensive periodontal assessments, deep cleanings (scaling and root planing), and tailored oral hygiene recommendations designed specifically for your mouth.

Contact Progressive Periodontics in Tigard, OR today to schedule your periodontal evaluation!

Waterpik Vs. Flossing Should I Use One or the Other? Or Both!