Flossing guide

How often to clean between your teeth

The ADA recommends brushing twice a day and cleaning between teeth once a day with floss or another interdental cleaner, and says the time of day is flexible. Cleveland Clinic also advises flossing daily and brushing twice a day for two minutes. See our guide on flossing twice a day for the details on frequency.

How to floss

Cleveland Clinic recommends about 24 inches of floss wrapped around both middle fingers, held taut with thumbs and index fingers, guided gently between two teeth in an up-and-down motion following the curve of each tooth, not pushed too far into the gums, with a clean section for each set of teeth. The ADA adds that waxed and unwaxed floss work equally well and that flossing before or after brushing is acceptable.

Floss, interdental brushes and water flossers

A 2019 Cochrane review described by the ADA found that floss or interdental brushes used with toothbrushing may reduce gingivitis or plaque more than brushing alone, and that interdental brushes may outperform floss, with low to very low certainty. Evidence for water flossers and cleaning sticks was limited and inconsistent. The ADA says the right choice depends on the person, with floss suiting tight spaces and interdental brushes suiting periodontitis or more open spaces. Do not reuse floss or interdental cleaners, according to the ADA.

Is it normal for gums to bleed when flossing?

It is common when you start, according to ADA MouthHealthy, because your gums are adjusting, and it usually goes away on its own in about a week. Cleveland Clinic says healthy gums should not routinely bleed during flossing, that occasional bleeding can happen, and that frequent bleeding suggests a deeper problem. If you floss daily, it says bleeding should stop within a few weeks.

Why gums bleed

Cleveland Clinic says plaque, tartar and bacteria along the gumline are the usual cause, and that not flossing daily is typically the main cause of bleeding gums, which can lead to gingivitis. Other causes include flossing or brushing too hard, a worn or hard-bristled toothbrush, hormonal changes from the menstrual cycle, birth control, pregnancy or menopause, puberty, and medical issues such as uncontrolled diabetes, leukemia, hemophilia or low vitamin C or K. ADA MouthHealthy lists gingivitis, pregnancy gingivitis, blood thinners and brushing too hard.

Flossing around braces, implants and bridges

If you wear braces, Cleveland Clinic suggests floss designed for braces, the AAO lists interproximal brushes and water irrigators for cleaning between teeth and around wires, and Healthline mentions a floss threader. The ADA notes that interdental brushes made for dental implants have a coated wire to avoid scratching the implant.

If you have a bridge, implant or other dental work, ask your dentist which tool and technique are best for it, because the right choice depends on the shape of your teeth and gums.

Gingivitis can be reversed

ADA MouthHealthy says gingivitis, the early stage of gum disease, is reversible and preventable. Cleveland Clinic says unchecked gingivitis can progress to periodontal disease, which is why routine cleanings twice a year are recommended. If your gums bleed regularly or enough to worry you, see your dentist or doctor, because it could indicate another problem.

If you take blood thinners

ADA MouthHealthy says blood thinners can make gums bleed, and that if bleeding does not stop quickly you should contact your physician. Do not stop any medicine without talking to the prescriber.

Making it a habit

Pick a time of day that works for you and attach it to something you already do. Use a tool you will actually use, whether floss, a floss holder or an interdental brush, because consistency matters more than the exact method. Your dentist or hygienist can show you the best technique for your teeth.

Guides in this topic

Frequently asked questions