The interproximal or interdental area is the gap that exists between teeth and that is occupied by the gums. Interproximal spaces facilitate the appearance and accumulation of oral biofilm (bacterial plaque), as they are hard to clean even when teeth are in a normal position.
The interproximal area makes it easy for oral biofilm to settle and develop, enhancing the development of caries and gum disease – gingivitis and periodontitis. To prevent these associated problems, or even halitosis, it is very important to be sure to remove the biofilm that accumulates in interproximal spaces.
Oral hygiene is not complete if oral biofilm is not removed from interproximal spaces.
The most common method for controlling oral biofilm is toothbrushing, but since access to interproximal surfaces is limited, it requires specific interproximal cleaning involving the use of dental floss or tape and/or interproximal brushes. Electric devices, such as oral irrigators, can also be used as interproximal hygiene compliments, because their pulsating irrigation is of proven efficacy.
Dental floss and tape are indicated for removing oral biofilm from tight interproximal spaces.
Interproximal brushes are indicated for cleaning wide interproximal spaces (when there is enough room between teeth), and in the premolar and molar areas, or in cases where gums have receded and a bigger and more accessible space exists. The most appropriate interproximal brushes are those that have quality filaments, such as rounded Tynex® filaments that do not harm the gums.
This type of brushes can also be used for applying antimicrobial substances, like, for instance, gels containing Chlorhexidine or Cetylpyridinium Chloride, to prevent caries or inflammation. A brush must be replaced when its filaments become loose or deformed.
Oral irrigation involves the direct application of a pulsating stream of water or other solution, to aid in the removal of bacteria from the surface of teeth, gum line, interproximal spaces and hard-to-reach areas such as periodontal pockets, bridges, crowns, orthodontic appliances, etc.
During interproximal cleaning, gingival bleeding can indicate the existence of inflammation. This does not imply that you should avoid interproximal cleaning, but rather just the contrary, that the inflammation should be treated.
It is important to note that the most current methods of interproximal cleaning are limited in their effectiveness by the ability or commitment of each person more than by the method itself1. Not all interproximal cleaning tools are suitable for all people or all types of teeth. When in doubt, consult with your dentist so that he/she can select the most appropriate hygiene method for you.
- Galgut PN. “The need for interdental cleaning”. Dent Health (London) 1991; 30:8-11.
- Warren PR, Chater BV. “An overview of established interdental cleaning methods”. J Clin Dent 1996; 7:65-69.