Toothpicks/Interdental Stimulators

Triangular wooden tips and/or interdental stimulators may be inserted in interproximal areas and can remove some plaque interdentally. While these tools may be better accepted by patients than flossing, they demonstrate no overall reduction in plaque or gingival index when compared to toothbrushing alone.102 Their use is associated with a reduction in BOP that is similar to that seen with flossing.102 In patients with established gingivitis or mild periodontitis, the use of an interdental toothpick and toothbrushing use was less effective than flossing and toothbrushing in reducing plaque and bleeding scores.102 For these reasons, use of toothpicks as a sole method of interdental cleaning cannot be recommended.