Maintaining oral hygiene requires effective cleaning not only of visible tooth surfaces but also of interdental spaces, areas between teeth where plaque accumulation is common. While toothbrushes clean accessible surfaces, specialized tools such as interdental brushes are designed to target hard-to-reach regions.
The concept of interdental cleaning tools dates back to the late 19th century. One of the earliest documented designs was described in 1882 by Hermann Heuschmann, who introduced a toothbrush consisting of a twisted brush capable of rotating within a partially open outer shell.
By 1903, variations of twisted brushes were incorporated into water irrigation devices, reflecting early attempts to combine mechanical and fluid-based cleaning methods. Historical advertisements and dental catalogues from the early 20th century, show the development of small spiral brushes designed to clean:
Denture clasps
Interdental spaces
Areas around prosthetic appliances
These early innovations laid the foundation for modern interdental brushes. 1
Initial designs were:
Cylindrical in shape
Made with coiled wire and bristles
Lacked angulation or ergonomic handles
By the mid-20th century, interdental brushes (IDBs) became more widely used, particularly from the 1960s onward.
Research in the 1970s demonstrated that:
Filament length influenced plaque removal depth
Longer bristles (~3 mm) enabled deeper subgingival cleaning (up to ~3 mm)
Design improvements included:
Conical shapes for better fit
Angled handles (~70°) for easier access
Variations in filament density
By the 1980s and 1990s, studies began to evaluate their clinical effectiveness, often showing improved plaque removal compared to traditional floss.
See also: Water Flosser vs Interdental Brush: Which Is Better for Oral Health?
A major milestone in standardization was the introduction of ISO 16409:2016, which defines:
Performance requirements
Safety criteria
Labelling and usage guidelines for manual interdental brushes
This standard allows for:
Quality benchmarking
Comparison based on parameters such as Passage Hole Diameter (PHD)
However, some limitations remain, including variability in size classification and lack of precise correlation between brush size and interdental space dimensions.
Modern interdental brushes are available in various designs:
Cylindrical
Conical
The interdental brushes are called bottle brushes or Christmas brushes based on its shape of the bristle tip.
Multiple sizes (as per ISO classification)
Selected based on interdental space width
Straight brushes
Angled brushes
Replaceable heads with handles
These variations allow customization according to individual oral anatomy.
Proper technique is essential for effectiveness:
Select the appropriate size recommended by a dental professional
Gently insert the brush between teeth without force
Move it back and forth to remove plaque
Clean multiple interdental spaces systematically
Rinse the brush after use
Clinical guidance from dental health services emphasizes avoiding excessive pressure to prevent tissue injury.
Clinical studies over decades have evaluated interdental brushes. Early research indicated superior plaque removal compared to dental floss.
Systematic reviews initially supported their effectiveness, especially in patients with periodontal disease. However, more recent analyses highlight variability in study quality and limited high-strength evidence in some areas.
Despite this, interdental brushes remain widely recommended in dental practice.
Interdental brushes are particularly used by:
Patients with periodontal disease
Individuals with larger interdental spaces
People with dental prosthetics or orthodontic appliances
General population usage varies, often influenced by awareness of interdental cleaning for periodontal health.
Common people take it up generally after their dentist's professional advice.
Interdental brushes have evolved significantly from early twisted brush designs of the 19th century to modern standardized oral hygiene tools. With advancements in design and growing clinical evidence, they remain an important component of interdental cleaning, particularly in individuals with specific dental needs.
References
Staehle, H. J., and C. Sekundo. “History of Interdental Brushes: Origins, Developments, Perspectives.” Oral Health & Preventive Dentistry 23 (January 8, 2025): 1–20. https://doi.org/10.3290/j.ohpd.c_1800.
Sekundo, C., and H. J. Staehle. “Mapping the Product Range of Interdental Brushes: Sizes, Shapes, and Forces.” Oral Health & Preventive Dentistry 18, no. 2 (July 4, 2020): 343–354. https://doi.org/10.3290/j.ohpd.a44035.
