Interproximal hygiene must be carried out daily in order to keep biofilm from building up and to prevent the onset of caries and periodontal and peri-implant diseases. 

The most important hygiene tools for cleaning the interproximal area are interproximal brushes, dental floss or tapes and oral irrigators. It is imperative that oral health professionals teach people how to properly use the different tools that exist, and that the routine implemented is based on their own individual case. 

DENTAL FLOSS OR TAPE 

When the papilla completely occupies the interproximal space, it is recommended to use dental floss or tape. These must be made of a material that resists the passage between the teeth without breaking and that is, at the same time, capable of sweeping away oral biofilm and food debris. They may contain wax, which helps them slide easily between teeth and, if they are flat, as is dental tape, they will be able to slide between very narrow interdental contact points. They may also contain fluoride to help prevent interdental caries. 

When properly used, dental floss and tape have been shown to be effective in reducing interproximal caries⁽¹⁾. 

INTERPROXIMAL BRUSHES 

When interdental spaces are open, it is most appropriate to use interproximal brushes. The most highly recommended are those that have filaments made of quality materials (such as Tynex^®), capable of disrupting and removing biofilm and food debris, and whose wire is covered with a material that does not damage teeth and gums. 

It is necessary to choose the appropriate brush size for each interproximal space, and the brush head shape, which may either be cylindrical or conical. The conical ones are recommended for spaces between molars and premolars, as they are better at cleaning line angles and embrasures, while the cylindrical ones are advisable for all other interdental spaces. 

Also, when periodontal disease or more apical furcations and concavities exist, conical brushes may be more effective. It is important to place them at the proper angle depending on whether they are used in the upper or lower arch, or in an inward or outward direction. 

Interproximal brushes have proven to be the most effective implements for removing interdental plaque ⁽²⁾. 

ORAL IRRIGATORS 

For all interdental spaces and, particularly, for those areas that are more complicated to clean, oral irrigators can be of great help. The most highly recommended are those whose mechanism involves the generation of a pulsating stream of water (or other solution), providing a decompression/compression phase that helps break up the biofilm built up around the teeth and/or implants. 

Oral irrigators have been shown to be very effective in controlling and reducing gingival inflammation⁽³⁾.