1. Tooth decay between the teeth - this type of decay cannot be accessed directly which means we have to remove some healthy tooth from the biting surface above the decay to get down to the area of decay between the teeth. If there is no improvement in diet and interdental cleaning repeat fillings may be needed. Once the filling has been placed there can still be further decay just below the base of the filling meaning the filling has to be replaced. The fillings get bigger, the tooth gets weaker and the tooth may end up needing a crown, root canal work or may even need to be extracted.
2. Gum Disease - the large proportion of gum disease we see by far occurs between the teeth. Plaque nestles just below the gumline between the teeth, remaining indefinitely if the patient is not cleaning between the teeth. The presence of the plaque leads to a 'war' between the plaque bacteria and the body's immune defences. The collateral damage is that bone is destoyed in this area and will never re-grow. The leads of a bigger area or 'pocket' that plaque can collect in and as more bone is destroyed and the pocket gets deeper it becomes increasingly difficult to clean out even with good interdental cleaning. Eventually it becomes impossible and the tooth will eventually be lost.
So what can you do?
Interdental cleaning is the process of cleaning between the teeth. There are various products that can be used for this, most commonly floss and interdental brushes such as Tepe brushes. There are also more expensive options that use a jet of air or water to blast plaque out from between the teeth. Personally I prefer interdental brushes to floss most of the time as I feel floss just moves the plaque around and doesn't clear it as effectively as a brush. However where the teeth contacts are tight especially in younger patients in their teens and twenties floss may be sufficient. Floss has an added benefit that it does clear plaque from the actually point of contact between the teeth, which is often the point where decay starts in younger patients. Interdental brushes work more on the little triangular space below where the teeth touch; this is where we see gum disease and decay in older patients. They are tiny bottle brushes that can pick up and remove plaque very effectively.