Flossing is considered a critical part of maintaining good oral health and hygiene today. Most dentists recommend flossing at least once per day to remove plaque and food particles between teeth and prevent tooth decay and gum disease. However, flossing is a relatively modern dental hygiene practice. So what did people use to clean between their teeth before the invention of floss?
Toothpicks
Toothpicks are one of the earliest and most common tools used for cleaning between teeth. Archaeological evidence shows toothpicks made of wood, bone, quills, bronze or silver date back to as early as 3000 BC in Mesopotamia and Egypt. Various cultures across the world have used toothpicks crafted from wood, bamboo, feathers, animal bones, gold, silver and other materials.
Toothpicks continued to be the primary interdental cleaning tool in America and Europe up until the early 19th century. Machine-cut wooden toothpicks were first mass produced in America in the 1860s. Toothpicks made of softer wood like birch were gentler on the gums compared to harder wood picks. Flavored toothpicks containing mint, cinnamon or other essences also became popular in the late 19th century. While effective for dislodging large particles, toothpicks cannot remove plaque or clean as deeply between teeth as dental floss.
Horsehair, Silk and Linen Threads
Horsehair, thin silk or linen threads were also used historically for cleaning between teeth. Sources from China during the Tang Dynasty around 618-907 AD mention using horsehair attached to a bamboo stick as a primitive dental floss. Silk fibers were also teased apart and used to floss the teeth in ancient China.
In the Western world, unraveling a silk or linen thread and using it to clean between teeth dates back to pre-Roman times. The Greeks and Romans continued this practice, using horsehair or linen thread to prevent gum disease and tooth decay by removing debris between teeth. However, these threads shredded easily and could not be used repeatedly. So they were a disposable tool rather than a durable flossing implement.
Rubber/Plastic Dental Floss Emerges
The first commercial unwaxed silk floss for dental hygiene was manufactured in 1882 by Codman and Shurtleft Company. In 1898, the Johnson & Johnson company received the first patent for modern dental floss made of multiple silk or linen threads twisted together and treated with wax.
Unwaxed silk floss was notorious for shredding and breaking easily during flossing. The key innovation of the new Johnson & Johnson floss was the light wax coating, which strengthened and smoothed the floss for gentler cleaning between tight teeth. This attracted dentists to recommend it to patients. Various floss products using silk or nylon fibers emerged through the early 20th century.
In 1939, nylon was invented as a synthetic polymer fiber. Nylon floss quickly became the preferred option due to its high strength and resistance to breaking. Dr. Charles C. Bass is credited with pioneering nylon dental floss in the 1940s. Throughout the 1950s and 60s, unwaxed and waxed nylon floss surged in popularity and replaced silk dental floss.
Modern dental floss first emerged in the 1960s and 70s using advanced nylon, PTFE (Teflon) or polyethylene fibers. New waxes and coatings were developed to make the floss even stronger and easier to slide between tight spaces. Floss with a stiff molded plastic handle also allowed users to better grip and control flossing.
Flavored dental floss like mint and cinnamon also became popular. Some flosses added water-repelling wax or menthol coating for a cooling effect. Floss with baking soda or other active ingredients to whiten teeth or reduce gingivitis also emerged. Present-day dental floss has evolved into a highly engineered, user-friendly product.
Toothbrushes and Miswaks (Chewing Sticks)
Ancient tooth-cleaning sticks called miswaks have been used since prehistoric times up to today. Miswak sticks come from the fibrous Salvadora persica tree native to parts of Africa, Asia and the Middle East. Chewing on one end splits the wood into bristly, brush-like fibers. The frayed end can then be used to scrape plaque off teeth. The fibrous sap has a natural anti-bacterial effect and freshens breath.
The bristly pig hair toothbrush originated in China around 1600 BCE. Pig hair bristles were softer than horsehair brushes, while still being firm enough to clean teeth and massage gums when chewed. The handle was carved from bone or bamboo.
In Europe and America, rudimentary toothbrushes made from horsehair or feathers attached to bone, bamboo or wood handles were common from the 1600s to 1800s. Natural bristle toothbrushes with hog hair emerged in the early 1800s in England and gained popularity in the U.S. Modern nylon bristle toothbrushes were mass produced after 1938.
While toothbrushes help clean tooth surfaces, they cannot remove debris between teeth as effectively as floss. But before floss became widely available, toothpicks, chew sticks and primitive bristle brushes were the main way people cleaned their teeth.
Chewed Fibrous Foods
Fibrous foods that people had to chew vigorously acted as primitive cleaning tools for teeth. Primitive diets included coarse, fibrous vegetables, roots, nuts, meats and dried foods. Eating them required prolonged, vigorous chewing that helped scrub away buildup on teeth.
Ancient people did not eat processed or refined sugars and carbohydrates that cause substantial plaque buildup. Their tougher, fiber-rich foods and lack of sugary diets resulted in less plaque and tooth decay than the average modern diet. The physical abrasion from chewing fibrous foods helped clean debris from teeth. So in a sense, some of the earliest dental cleaning devices were the coarse foods early people ate.
Rinsing Water
Since ancient times, rinsing the mouth and teeth with water has been a basic oral hygiene practice after eating. Water helped clear food debris, dislodge particles and cleanse the mouth. Ancient Greek and Roman literature shows people rinsing with water after meals and in the mornings to refresh oral hygiene.
But simply swishing water cannot remove sticky plaque or food trapped between teeth like flossing can. Water alone does not physically disrupt and remove debris between teeth. So while rinsing remained important, people still needed tools like floss to actively clean between teeth and prevent plaque buildup, even centuries ago.
Mouthwashes and Tooth Powder
Early mouthwashes and abrasive tooth powders also predated modern dental floss as oral hygiene tools, although they were ineffective at cleaning between teeth. Since 3000 BC, ancient Egyptians and Greeks used crude mouthwashes made with wine, vinegar or salt water solutions. They also scrubbed teeth with tooth powder containing crushed oyster shells or charcoal to try removing staining or odor.
However, these primitive mouthwashes and powders were limited in effectiveness and could not reach deep between teeth. Loose abrasive particles were also harmful to enamel over time. So flossing was still required to thoroughly clean tight spaces between teeth and along the gumline. Mouthwashes and powders did complement flossing, but could not replace it.
Finger Rubbing
Before purpose-made dental cleaning tools, using fingers to rub teeth was likely a common practice, even dating back to prehistoric times. Rubbing teeth with fingers can help loosen debris, massage gums and spread saliva over tooth surfaces. Saliva contains enzymes and minerals that protect teeth and kill bacteria.
However, only floss can physically scrape and wipe away plaque, food and bacteria from tight spaces between teeth and just under the gumline. Rubbing teeth with fingers or cloth is not as targeted and effective as sliding floss against two adjacent tooth surfaces. So manual cleaning methods were still needed in oral hygiene regimens.
Chew Sticks Worldwide
| Region | Type of Chew Stick |
|---|---|
| Middle East | Miswak |
| Ancient Greece | Mastic tree twigs |
| Ancient Rome | Licorice root, myrrh |
| South Asia | Neem, babool, mango tree sticks |
| West Africa | Sticks from orange trees, kola nuts |
| East Africa | Sticks from Salvadora persica trees |
Conclusion
While flossing is considered essential today, people historically relied on more rudimentary oral hygiene tools. Toothpicks made of wood, quills or bone were used worldwide since 3000 BC. Horsehair, thin silk, linen or hemp threads also served as early floss. Chew sticks from trees like miswak and neem have been popular for millennia in Asia and Africa. Pig hair toothbrushes originated in China in 1600 BCE. And fibrous, coarse foods acted as primitive cleaning tools when chewed.
However, these early methods had limitations in their ability to remove plaque and clean difficult to reach spots as effectively as purpose-made dental floss. Primitive flossing threads broke easily, chew sticks quickly frayed and became ineffectual, and brushes could not clean between tight teeth. None of these tools matched nylon floss’s durability, gentleness on gums and ability to clean thoroughly between teeth and under the gumline.
Floss truly revolutionized dental hygiene after emerging commercially in the 19th century. While people tried cleaning between their teeth with various makeshift tools for centuries, only proper flossing provides the most complete and effective interdental cleaning. After floss became widely available and affordable, it quickly rendered the earlier tools obsolete and became essential for proper oral hygiene.