Here's a question that isn't all that uncommon for a dentist to hear. A patient will ask, can I just rinse with a mouthwash instead of flossing? We'll, we hate to be the bearer of bad news but no, mouthrinses are not an effective alternative to proper flossing.
It doesn't take much to understand why. Flossing involves the mechanical debridement of tooth surfaces. Just like toothbrush bristles whose purpose is to scrub the surface of teeth, dental floss is a tool whose intended purpose is to scrub (or scrape) dental plaque off a tooth's surface in those regions where toothbrush bristles cannot reach. That's why proper flossing technique involves holding the dental floss up against a tooth and sliding it along its full length (even below the gum line), not just in and out of the contact area where two teeth touch.
Only mechanical debridement (scrubbing and scraping) can adequately dislodge dental plaque from a tooth surface. Oral rinses may "soften" plaque (make it less adherent) or be antibacterial in nature, but neither of these properties allows a mouthwash to be even fractionally as effective as brushing and flossing.
A part of the problem is associated with the failure of oral rinses has to do with the nature of dental plaque. Even though a layer of plaque can be quite thin, it is remarkably protective to the bacteria that live within it. Oral rinses can have an effect on the bacteria that live on its surface but will have a very limited effect on those that live within it. This means that when a mouthwash is used the bacterial population living in the plaque is only somewhat affected. In comparison, scrubbing dental plaque off a tooth's surface significantly breaks up the bacteria's homey little microcosm. And this action goes long way toward making their life miserable, in the since that they must now start from square one in rebuilding their colony.
Yes, in January 2005 Southern District of New York Judge Denny Chin issued a finding that enjoined Pfizer, Inc. (the makers of Listerine Antiseptic Mouthwash) from making the claim in their advertising that the use of their oral rinse is "as effective as floss." Judge Chin stated that he found the clinical studies on which this claim had been staked were flawed and did not support the advertised statement. He also felt that Listerine's ads could pose a public health risk, from the standpoint that they might convince consumers that they did not need to floss daily.
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