“Brush and floss or prepare for loss.” It’s a mantra that has seen many a bathroom bin transformed into a sticky snake pit of discarded threads. But an investigation by the Associated Press now suggests our dentists may have been stringing us along. Freedom of Information requests to the US Department for Health and Human Services (HHS) asking for the evidence underpinning its recommendation for daily flossing have prompted the organisation to quietly drop this advice. Public Health England has also said that it will be reviewing its own guidance on flossing in the New Year. So if dental floss is now dross, what else can we do to keep our mouths healthy?

Here are four alternatives.

Invest in interdental brushes

The evidence for interdental brushes reducing gum disease is slightly stronger than for dental floss, though still weak. And some people struggle to fit even the smallest size of interdental brush between their teeth because they’re packed so closely together. But in spite of the lack of strong evidence,it is worth trying to get something in there, says the British Society of Dental Hygiene and Therapy. “Toothbrushing alone cleans only three of the five surfaces of our teeth, so cleaning between our teeth is a critical part of good oral hygiene as it helps to prevent gum disease by removing plaque from any areas missed by brushing alone,” says Michaela ONeill, president of the BSDHT.

Try using “water-picks”

If you can’t squeeze a brush in there, how about a high-pressure jet of water to dislodge the plaque? So-called water picks are an alternative to interdental brushes. “They’re an expensive option, and I’m not sure the evidence has been shown for those,” says Derek Richards, director of the Centre for Evidence-based Dentistry at the University of Dundee. However, the same basic principle of dislodging bacteria from between your teeth applies. One thing to bear in mind is that it will rinse away the fluoride in toothpaste that strengthens your teeth, so if you are going to squirt, do it before brushing, not afterwards.

Visit your dental hygienist

Even the most dedicated toothbrusher may routinely miss bits, and when they do, plaque can harden into tartar. Not only is it unsightly; it gives plaque more surface area on which to grow. The only way to remove it is to scrape it off, which is where dental hygienists come into their own. Even so, when the Cochrane Oral Health Group – a team of dentists that regularly reviews and summarises the best available evidence – recently looked at whether a regular scale and polish reduced plaque build-up and gingivitis, it found insufficient evidence to either support or refute such claims.

Brush, brush, brush

Regular toothbrushing remains the most effective way to care for your teeth and gums. Not only does it remove much of the plaque that causes gum disease, but the fluoride in toothpaste helps prevent tooth decay by strengthening the teeth. And although manual brushing works, for all-round oral health, the strongest evidence is for electric toothbrushes. When the Cochrane Oral Health Group recently compared the two methods over three months, electric brushes were associated with a 21% reduction in plaque and an 11% reduction in gum inflammation compared with manual brushing.