A water pick, which is an instrument used in oral prophylaxis, removes food particles and plaque from the interdental gaps and sulci with the aid of a water jet. However, it does not replace the toothbrush. The toothbrush only cleans the tooth structure visible in the oral cavity, whereas the water pick destroys plaque underneath the gums (gingiva) as well, in the so-called sulcus.
The animation shows the cross section of a tooth. One can recognize the bone, the root of the tooth, the periodontal membrane, and the gingiva. These structures are collectively called the periodontium. Normally, the gingiva begins at the Cementoenamel junction, i.e., at the junction where the dental enamel transitions into the root cementum.
At this point, they form the so-called sulcus, an area where the gingiva is not connected to the tooth but fits tightly around it. The sulcus depth may be 0–3 mm. Plaque is the name for the biofilm that forms on tooth surfaces; plaque causes caries and periodontitis. This biofilm is formed by bacteria from saliva combined with food particles lodged on the teeth.
In the past, it was believed that water picks flushed bacteria deeper into the sulcus; therefore, this tool was rejected. Currently, individuals are aware that bacteria move on their own by means of small appendages (called cilia and flagella); therefore, they can enter the sulcus whether or not a water pick is used.
Also, it is not about destruction of the bacteria themselves, but about restricting their ability to organize and become mature plaque. To destroy the mature Plaque is important and this is done by the water jet – even in the sulcus, where the Tooth Brush doesn´t work.
This animation shows the correct application of the water pick. The stream should be pointed at the sulcus and moved along the margins on both the front and back surfaces. It should be moved from tooth to tooth, briefly stopping at the interdental gaps. The gums may bleed initially; it is only a sign of inflammation. With regular use, the gums will recover quickly. The strength of the water stream should be set to a level that is comfortable to the patient, who can increase its intensity as required.