Barry Oulton explains how to challenge a patient’s disinclination to clean interdentally, simply and easily, by encouraging habit creation

We are creatures of habit. Without realising it, our subconscious routines make our lives so much easier.

Consider making breakfast. You reach for and fill the kettle, push the button without looking to get it boiling, simultaneously reaching for your mug and popping in a tea bag. While you wait for the water to reach temperature, you take the milk out the fridge, turn 90° to the counter to put it down, nudge the fridge door closed with your elbow, get a bowl and spoon with your left hand and, with your right, look in the cupboard to decide which cereal you fancy.

There’s a lot going on there when you look at it in writing, but it happens easily and efficiently because they are all habits.

Now imagine staying over at a friend’s house and coming into the kitchen for breakfast. Where’s the kettle? The mugs and the teabags? Which of the milks in the fridge should you choose and why isn’t the door closing properly? Can’t find the bowls, spoons or cereal?

You’re out of your everyday routine and suddenly breakfast is a complicated scenario where you might be tempted to skip a few steps or forget something. The same is true of an oral health regime, especially when it comes to interdental cleaning.

Force of habit

We like to think we are in control, mindful of everything we do, but, the truth is, most of the time we simply react instinctively to our environment. That’s an important distinction when it comes to motivating patients to embrace an effective brushing and interdental cleaning routine at home between appointments.

Most patients are pretty good at brushing twice a day, but interdental cleaning remains an enigma for many. The key to success with this is to make it a habit, creating a mental connection between a trigger thought or event (stimulus, trigger or cue) and our response to that trigger (the response or routine).

Repeating this connection starts to form a habit and, if replicated often enough, this link becomes near permanent, unless we take conscious action to change it or something occurs to break the link (for example, running out of interdental brushes and not replacing them for a few days).

I want my patients to brush twice daily and clean interdentally once a day. Because they are happening at different intervals, brushing may not be the ‘cue’ to interdental cleaning. So, you want to ask your patients to link the action of cleaning between their teeth to something other than tooth brushing that happens only once a day, perhaps having a shower.

I invite them to purchase a Wisdom flossing device from reception. These are colourful and so easily spotted, and I recommend that, for the first few weeks at least, they are kept within their eye line when in the shower.

Over time, the habit of interdental cleaning is developed because it becomes a part of their once-daily showering routine rather than their twice-daily brushing routine.

A reason why

Patients do need a reason to form this habit; it’s not enough for us to say ‘because it keeps your teeth clean’.

They need an emotional reason that resonates for them. We humans are motivated, in part, by avoiding pain and gaining pleasure. So, motivating information may include that interdental cleaning helps to reduce bad breath and not cleaning interdentally increases bad breath. Bad breath can lead to rejection, embarrassment, negative comments, becoming self-conscious and loss of confidence. There we have the reasons to share with patients to motivate them to form the habit.

Working with what you have

We also often come across objections, such as, ‘I can’t reach my back teeth’, ‘I’m all fingers and thumbs’ or ‘I hate flossing’. Happily, these are pretty easy to overcome when you know how.

Once you have communicated the importance of an effective home care regime and motivated your patient to put the effort into making brushing and interdental cleaning a habit, it is important to take the time to recommend products based on their needs and any physical limitations.

I find it best to recommend products I use personally and rate highly. My go-to product is the Wisdom Easy Flosser, which I find effective and easy to use. With replacement harps, it has a long handle design, allowing easy access to difficult to reach areas, including the back of the mouth.

An alternative product that may meet a patient’s needs is the wire-free Wisdom Clean Between Rubber Interdental Brush for pain-free cleaning. Clinically proven to reduce gum disease, the tapered design allows the brush to slide easily between teeth, while the soft flexible rubber filaments – which are gentle on the gums – enable effective cleaning. As they are wire-free, they are also ideal for patients who struggle with wire interdental brushes and for cleaning around orthodontic appliances, implants, metal fillings and crowns.

For patients with limited dexterity, the Wisdom Clean Between Easy Slide Y-shaped Tensioning Flossers with advanced silk-like tape are easy to use. With a tension control system to hold the flossing tape taut, they slide effortlessly into even tight gaps between the teeth, helping to make it easier to remove plaque and food particles for cleaner, healthier teeth, while being gentle on the gums.

If a wire interdental brush is preferable, the curved handle of Wisdom Pro Flex Wire Interdental Brushes helps to improve access to difficult to reach areas at the back of the mouth. With its flexible hinge, the brush is also less prone to breakage or bending. The wire is coated for use around metal fillings and to prevent sensitivity.

These are just some of the products available in Wisdom’s oral care portfolio, designed to help make interdental cleaning easier.

Sending the right message

If you would like to learn more about effective communication, Wisdom and The Confident Dentist Academy are working together on a highly innovative educational campaign to support dental professionals to encourage habit change in patients.

Experts in oral care and working for improved oral health, Wisdom is dedicated to delivering leading-edge products across the UK, meeting all of a family’s oral hygiene needs. 


A webinar dedicated to habit change, presented by Barry Oulton, will be available later in the year. He will also be speaking at the BSDHT Conference on Friday 22 November in a presentation entitled ‘The wisdom of great oral hygiene habits’. For more information on the range of products by Wisdom, visit https://wisdom-toothbrushes.comhttps://wisdom-toothbrushes.com

For further details about Dr Oulton and The Confident Dentist Academy, visit www.theconfidentdentist.com