IT IS ONE of the most ordinary questions in dental care, yet the answer has generated years of debate.
Should you floss before brushing your teeth, or brush first and floss afterward?
Dentists say the good news is that both approaches can be effective. The more important issue is whether people clean between their teeth regularly and brush thoroughly. The American Dental Association (ADA) recommends brushing twice a day and cleaning between teeth once a day with floss or another interdental cleaner.
Still, there is scientific evidence suggesting that flossing before brushing may have an advantage.
A randomized clinical trial published in the Journal of Periodontology compared the two sequences among 25 dental students. Participants were asked to floss before brushing during one phase and brush before flossing during another. Researchers found that flossing first produced a greater reduction in plaque between the teeth and higher fluoride concentrations in those areas after brushing.
The reasoning is relatively simple.
Dental floss is designed to reach spaces that toothbrush bristles cannot adequately clean. Moving floss between teeth can loosen plaque and food particles. Brushing afterward can then remove much of the material dislodged during flossing while spreading fluoride toothpaste across the teeth and into interdental areas.
The American Academy of Periodontology said the study suggested that flossing before brushing could provide a more thorough plaque-removal routine and help maximize the benefits of fluoride toothpaste.
But dentists caution against turning the sequence into an absolute rule.
The ADA’s position is that either order is acceptable as long as the cleaning is done properly. Some people prefer flossing first because it removes debris before brushing, while others find it easier to maintain a routine by brushing first. Ultimately, the best sequence may be the one a person will consistently follow.
Technique also matters. Floss should be guided gently between the teeth rather than snapped forcefully against the gums. The floss should curve around each tooth and be moved carefully along the tooth surface. People who find conventional floss difficult to use can consider interdental brushes or water flossers, depending on their dental needs.
For people wearing braces, bridges or other dental appliances, specialized interdental cleaning devices may make it easier to reach areas where food and plaque accumulate.
Another important consideration is timing. Many dental professionals recommend making interdental cleaning part of an evening routine, but the ADA emphasizes that there is no single mandatory time of day. What matters most is consistency.
The debate over flossing order therefore has a relatively practical conclusion.
If choosing one sequence, flossing before brushing has some research support. But flossing after brushing is far better than skipping it altogether.
For oral health, dentists say the winning routine is not necessarily the one performed in a particular order. It is the one performed thoroughly and every day.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
