Oral surgeon urges water flossing to reduce gum inflammation linked to systemic disease
With nearly half of U.S. adults affected by periodontal disease, experts say a steady stream of water can reach spots string floss misses and help protect overall health
An oral and maxillofacial surgeon is urging patients to add water flossing to their daily routines, saying a pressurized stream of water can help prevent gum infections that research links to broader health problems such as heart disease and diabetes.
"Gum health isn’t just about supporting your teeth. It’s about protecting your whole body," said Dr. Jason Auerbach, founder of MAX Surgical Specialty Management and Riverside Oral Surgery in New Jersey. With September observed as National Gum Care Awareness Month, Auerbach described water flossing as a practical tool to reduce bacterial buildup along the gumline.
Gums anchor teeth and form a protective seal that blocks bacteria, food debris and infection from reaching tooth roots and the jawbone. When bacteria accumulate on teeth they form plaque, which can harden into tartar. Toxins released by plaque can inflame the gums — a condition called gingivitis. If left untreated, gingivitis can progress to periodontitis, damaging bone and potentially causing gum recession and tooth loss.
Auerbach pointed to a growing body of evidence tying chronic oral inflammation to systemic conditions. "We now know that inflammation in the gums can fuel systemic problems like cardiovascular disease and diabetes," he said. The Centers for Disease Control and Prevention estimates that about 47.2% of American adults have some form of gum disease.
Water flossers, sometimes called oral irrigators, use a focused stream of water to dislodge plaque and debris in areas that toothbrushes and string floss may miss. Auerbach described water flossing as both easier to use and more effective for many patients, advising users to fill the reservoir with warm water, insert the tip, lean over a sink and aim the stream at the gumline, covering both the front and back of each tooth.
A 2024 study from India found that water flossers outperformed string floss in removing plaque from hard-to-reach spaces, boosting interest among clinicians and patients. Auerbach recommended using a water flosser twice daily as part of a comprehensive oral hygiene regimen that includes regular brushing and dental checkups.
Practical considerations for consumers include device pressure, reservoir size and splash control. While traditional waxed string floss can cost a few dollars per pack, countertop water flossers start at about $20 and can be substantially more for models with higher pressure settings and multiple tips. Auerbach recommended established brands that deliver steady pressure and minimal leakage, citing Waterpik as an example.
Risk factors for periodontal disease include smoking, unmanaged diabetes, genetic predisposition and poor oral hygiene. Dentists and surgeons emphasize that addressing gum inflammation early can reduce the chance of progression to deeper infection and tooth loss, and may contribute to better overall health outcomes.
Clinicians caution that a water flosser is not a replacement for professional dental care. Patients with existing periodontal disease, loose teeth, implants or recent oral surgery should consult a dental professional before beginning new home therapies. Regular dental examinations remain the standard for diagnosing and treating periodontal conditions.
As awareness campaigns highlight the connections between oral health and systemic disease, clinicians say simple additions to daily care — including water flossing when appropriate — can play a role in reducing inflammation and protecting both oral and general health.