Dental hardware changes how you clean between your teeth, not whether you should. Where string floss physically can't reach (under bridgework, around implant bases, behind archwires), studies show a directed water stream helps control gum bleeding around implants and brackets.1, 2 Floss threaders, threader floss, and interdental brushes adapt the mechanical approach where string can still get in.
How does hardware change the job?
It changes the geometry, not the importance. Cleaning between ordinary teeth is a straightforward mechanical task: slide floss into the gap, wipe the sides, move on. Dental work breaks that geometry. An orthodontic wire runs across every gap it crosses, so floss can't drop in from the top. A bridge is fused into one piece, so there's no way through between the connected crowns: only underneath. And an implant meets the gum differently than a natural tooth does, creating contours around the base that a straight strand of floss doesn't naturally follow.
None of this makes cleaning between teeth less important. If anything, hardware gives plaque more surfaces to cling to and more sheltered corners to collect in. It just means the standard tool needs help, or a different delivery method entirely.
Where does a water stream go that string can't?
This is the situation where water flossers have their strongest evidence-backed case. For people with braces, implants, or bridges, a directed water stream reaches areas string floss physically can't (under bridgework, around implant bases, behind archwires), and studies show it helps control gum bleeding around implants and brackets. A 2025 systematic review of oral irrigators and a 2025 randomized controlled trial both point in that direction.1, 2
Where string floss physically can't go, a directed water stream can. And around implants and brackets, studies show it helps control gum bleeding.
The honest caveats, stated plainly: these are small studies with follow-up periods of six months or less, so the certainty of the evidence is low. And the research covers water flossers as a category of device: no finding here is about any particular brand or model. Bleeding control is also not the same thing as preventing gum disease outright; it's an encouraging, measurable early marker, and that's how we report it.
Do string tools still matter?
Yes: a water flosser isn't the only adaptation, and dental professionals generally recommend keeping mechanical cleaning in the routine where it's physically possible. The standard options:
Floss threaders: a stiff plastic loop that pulls ordinary floss under an archwire or beneath a bridge, so you can still wipe the tooth surfaces string was designed to clean. Inexpensive and effective, though slow: threading every gap in a full set of braces takes patience, which is exactly why so many people with braces quietly stop.
Threader floss ("super floss"): pre-cut strands with a built-in stiff end and a spongy middle section, made for exactly these situations. One less tool to juggle than a separate threader.
Interdental brushes: tiny bottle-brush heads that slide into the gaps between brackets and under wires. Guidelines commonly recommend them where the spaces are large enough, and many people find them faster and easier to handle than threaded floss.
None of these is graded superior to the others in the independent evidence: the practical answer is whichever combination you'll actually do every day. If that sounds familiar, it's the same conclusion our honest string-vs-water comparison reaches for mouths without hardware.
Why is the extra effort worth it?
Braces, bridges, and implants all represent significant investments in a mouth (of time, money, or both), and the tissue around them is exactly where neglect shows up first. Gums that bleed around brackets or an implant base are signaling inflammation in the one place you most want to keep quiet. The point of adapting your between-teeth routine isn't perfectionism; it's protecting the work that's already been done.
If you're navigating braces specifically, our daily-care guide to oral care with braces covers the full routine (brushing angles, timing, and habit-building) beyond the between-teeth question this article focuses on.
The bottom line
Dental hardware doesn't excuse you from cleaning between your teeth: it raises the stakes while making the standard tool harder to use. Threaders, super floss, and interdental brushes adapt the mechanical approach; a water flosser reaches where string physically can't, with early evidence it helps control gum bleeding around implants and brackets. Talk to your dentist or orthodontist about the right combination for your mouth, and then (the part no tool can do for you) use it every day.
Common questions
Can you floss with braces?
Yes, with help. An orthodontic archwire runs across every gap it crosses, so floss can't drop in from the top. A floss threader (a stiff plastic loop) or threader floss with a built-in stiff end pulls ordinary floss underneath the wire. Interdental brushes slide into the gaps between brackets, and many people find them faster to handle.
How do you clean under a bridge?
From underneath. A bridge is fused into one piece, so there's no way through between the connected crowns. A floss threader or super floss pulls ordinary floss beneath the bridgework, and a directed water stream reaches under it as well.1, 2
Do you need a water flosser if you have implants?
"Need" is stronger than the evidence supports. What the studies show is that a directed water stream helps control gum bleeding around implants and brackets, in small studies with follow-up of six months or less, so the certainty is low.1, 2 Bleeding control is also not the same thing as preventing gum disease outright; it's an encouraging early marker.
Which adaptation works best?
None is graded superior to the others in the independent evidence. Floss threaders, threader floss, and interdental brushes all keep mechanical cleaning in the routine, and a water flosser reaches where string physically can't (the same conclusion our honest string-vs-water comparison reaches). The practical answer is whichever combination you'll actually do every day.
Does dental hardware make gum problems more likely?
Hardware gives plaque more surfaces to cling to and more sheltered corners to collect in, and the tissue around brackets, bridges, and implants is where neglect shows up first. Gums that bleed around a bracket or an implant base are signaling inflammation in the one place you most want to keep quiet.
- Systematic review of oral irrigators and periodontal outcomes, 2025. PMC11779913. Small studies, follow-up ≤6 months; low certainty.
- Randomized controlled trial of dental water-jet use, 2025. PMC11855567. Small trial, short follow-up.