Inter-dental Brushes

Inter-dental or Inter-proximal Brushes

Various types of small and angled brushes have been designed and are marketed for brushing in-between the teeth in those hard to reach places. They are invaluable if you have larger gaps between your teeth or gum disease.

Periodontal disease causes the loss of supporting bone around your teeth, and your gums to recede, leaving larger spaces in between your teeth. These areas are difficult to clean and collect even more plaque, which often leads to further attachment loss and the disease progressing. It is a nasty cycle you must break, if you want to keep your teeth.

Using these little brushes is as important as brushing itself if you have this problem. I mean it! If you are serious about getting on top of your gum disease, this needs to part of your regular routine as much as brushing your teeth.

As I say to my patients, “ Meet your new best friend; the two of you are going to get to know each other very well and become life long buddies”.

Floss is useful for breaking the contact between these teeth, removing plaque in this awkward spot and dislodging any food that may have got stuck, but after this it becomes a little ‘lost in space’. If your have tight healthy gums then the wiping motion we have discussed, will help to remove remaining plaque- otherwise it is time to call in the ‘cavalry’- enter the ‘interdental brush’.

Why does it Bleed and Hurt when I use Inter-dental Brushes?

The first few days you spit out, as with floss, expect to see blood in your saliva. This should stop after about a week. Especially if you have gum disease, the gums can be significantly inflamed and swollen interproximally (in-between) and because of this, they bleed really easily.

Flossing and toothbrushing are quite ineffective at removing the plaque in these bigger gaps between your teeth so you often get gingivitis there.

“What’s the treatment for gingivitis?” You should know this by now… That’s it- Getting rid of the plaque. That’s what these little brushes are intended to help do.

It’s likely that only when you have had a dentist clean, these areas in between your teeth, are made truly plaque free.

So when you first use interproximal brushes, you are likely to find that your gums:

  • Bleed heavily
  • They are sore and hurt a little

As with flossing, it’s just a phase that you have to get through, in order to start reaping the benefits.

Floss and inter-proximal brushes-> remove the plaque -> gingitivis in-between the teeth clears up-> bleeding stops-> gums toughen up becoming pink, firm and healthy.


Which Interdental Brush should I use?

In Australia perhaps the most commonly used brushes are called pixters , in the UK they mainly use Te Pe’s.

Now you will probably be able to find home brand versions in your local chemist, pharmacy or supermarket- they all do pretty much the same job – but it is crucial to get the right size head for your particular gap.

The only other element that varies is the shaft- some are long with more bristles, others are small, thin, wide or flat. It doesn’t matter- just personal preference.

Your dentist or hygienist can help suggest which type and which size brushes would be best for your particular situation- once you know what’s best for you- stick to that brand and size unless the gaps change.

You may have a range of different sized gaps. If so, you may need a variety of sizes of inter dental brushes.

That said, you will commonly find there is one size somewhere in the middle that does the job pretty well for most of them.

How do I use Interdental Brushes?

Whatever the ‘make’, they are all used in pretty much the same way:

  • Your dentist or hygienist will recommend a suitable size interdental brush for you. The key is that you want some friction against the tooth surface on either side; this has a good cleaning effect, but not so much that it’s too tight and too difficult to manoeuvre.
  • Insert the brush from the outside (cheek side) through each of the spaces- it should fit snugly.
  • Wash the brush quickly under the tap after each tooth, so that you don’t simply just push the plaque you removed back into the next space.
  • Then insert the brush from the inside (tongue side) through each of the spaces. This is a bit more tricky and takes a bit of practice to get into the right positions but it is essential.
  • Again remember to wash the brush out between each tooth.

It doesn’t really matter if you do it before or after brushing. I generally recommend the following sequence:

Tooth brushing- flossing- interproximal brushing. However, as long as you are doing them in ‘some’ order- your teeth and gums will see the benefits.

The Do’s and Don’ts of Interdental Brushing


  • Do select a suitable size (or suitable sizes) for in-between your teeth
  • Do start in one position and end in the same position position- i.e. like your brushing, be systematic
  • Do put the brush in from both sides of the gap (inside and outside)
  • Do rinse it quickly after each gap
  • Do push it in gently and give it a little twizzle
  • Do continue to use floss
  • Do use the brushes once every evening. It’s important you go to sleep without food and plaque in between your teeth. Saliva (your natural protection) dries up when you go to sleep, so any sugar, plaque and food stuck in-between your teeth is much more damaging at this time. Using them in the morning isn’t necessary (unless you want to!).
  • Do change it once it starts to deform and looks a bit worse for wear


  • Don’t force it into any gaps where it doesn’t fit – you will hurt your gum, or end up creating space for the brush- just use floss in these places (or get a smaller brush).