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Can Waterpik reverse periodontal disease?

Periodontal disease, also known as gum disease, is a common condition affecting many adults. It occurs when plaque builds up on the teeth and gums, leading to inflammation and potential tooth and bone loss. Advanced periodontal disease is a serious condition that can lead to receding gums, loose teeth, and eventual tooth loss. As such, reversing periodontal disease is an important oral health goal.

Waterpik is a brand of oral irrigators that use a stream of water to remove plaque and debris between teeth and below the gumline. Water flossing is growing in popularity as an alternative or complement to string floss. Some studies suggest water flossers may be more effective at reducing gingivitis and plaque. This has led to the question of whether using a Waterpik can reverse the progression of periodontal disease.

What is periodontal disease?

Periodontal disease occurs in stages, progressing from gingivitis to mild, moderate and advanced periodontitis. The stages of periodontal disease are:

Gingivitis – This earliest, mildest stage is characterized by red, swollen gums that may bleed easily when brushing or flossing. At this reversible stage, no permanent damage has occurred.

Early periodontitis – Pockets form between the teeth and gums, measuring up to 4mm deep. Some minor bone loss may be present. At this mild to moderate stage, gum recession may start to become visible.

Moderate periodontitis – Gum pockets are 5-6mm deep. More bone loss and gum recession occurs. Tooth roots may become exposed.

Advanced periodontitis – Gum pockets extend 7mm or deeper. Significant bone loss causes teeth to loosen or drift. Tooth loss is likely over time.

Symptoms and causes

Symptoms of periodontal disease may include:

  • Red, swollen, tender gums
  • Bleeding when brushing or flossing
  • Gums receding from the teeth
  • Persistent bad breath
  • Pus discharge between teeth and gums
  • Loose or separating teeth
  • A change in bite alignment

Periodontal disease is primarily caused by poor oral hygiene that allows plaque bacteria to build up along and under the gumline. However, other factors can increase susceptibility:

  • Smoking
  • Diabetes
  • Medications that cause dry mouth
  • Hormonal changes in girls/women
  • Genetic predisposition
  • Stress
  • Clenching or grinding teeth

With proper oral hygiene and professional treatment, gingivitis and early periodontitis can be reversed. More advanced periodontal disease can usually be stopped or slowed if caught early.

Conventional treatment

Conventional treatment for periodontal disease typically involves a combination of:

  • Deep cleanings – Scaling and root planing cleans under the gumline to remove plaque and tartar.
  • Medications – Antibiotics or antimicrobial rinses fight infection and inflammation.
  • Oral hygiene instruction – Brushing and flossing properly is key to managing disease.
  • Follow-up care – Regular cleanings monitor disease progression.
  • Surgery – Flap surgery smoothes root surfaces and repairs bone damage in advanced cases.

The goal is to reduce pocket depth and inflammation, stop additional bone loss, and keep teeth intact. Success requires excellent at-home oral hygiene.

How Waterpik may help

Waterpik oral irrigators are designed to complement brushing and flossing by targeting plaque in areas that are difficult to reach. As the water stream flushes over the teeth and gums, it provides the following benefits that could aid in reversing gingivitis and periodontitis:

  • Removes plaque bacteria – The water jet flushes away disease-causing bacteria before they can adhere and form plaque.
  • Cleans deep gum pockets – The water pressure rinses plaque and debris from pockets up to 6mm deep.
  • Massages and stimulates gums – This improves gum health and reduces inflammation.
  • Freshens breath – By dislodging bacteria, it reduces bad breath odors.

Clinical studies on Waterpik effectiveness provide encouraging evidence:

  • In 4-6 weeks, Waterpik use reduced plaque and gingivitis more than brushing and flossing alone.
  • Waterpik reduced gum bleeding by up to 70% in just 14 days when added to brushing.
  • Patients with periodontal disease had an average 25% reduction in pocket depth after 8 weeks of Waterpik use.
  • Diabetics with periodontal disease had significant pocket depth improvement using Waterpik.

While more research is needed, the clinical data indicates consistent benefits from using Waterpik oral irrigation as part of routine home care.

Professional recommendations

Given the promising research, dental organizations like the American Dental Association (ADA) support oral irrigator use:

  • The ADA Seal of Acceptance certifies that available evidence supports Waterpik effectiveness.
  • The ADA suggests oral irrigation is a beneficial addition for many patients, including those with early gum disease.
  • Most dental professionals recommend oral irrigators as an effective enhancement to a good daily oral hygiene routine.

Experts advise using Waterpik as directed for optimal gum health:

  • Use warm water to help flush away more plaque bacteria.
  • Start on the lowest pressure setting and work up to avoid irritation.
  • Aim the tip at a 90-degree angle into the gum pockets.
  • Water floss difficult areas like under bridges or around dental work.
  • Water floss daily, preferably after brushing and flossing.

Is Waterpik the complete solution?

While Waterpik has benefits for gum health, experts agree it should not replace brushing and flossing entirely. Here are some considerations regarding Waterpik limitations:

  • The water pressure does not remove hardened tartar like professional scaling does.
  • It does not clean tooth surfaces or remove plaque between teeth like brushing.
  • The stream does not wrap around tight spaces between teeth as floss does.
  • Some residue may remain in pockets harboring bacteria.
  • It does not address underlying medical conditions contributing to gum disease.

For these reasons, using Waterpik alone is not likely sufficient to completely reverse advanced periodontal disease damage. The consensus of dental professionals is that oral irrigation should be used to enhance brushing and flossing for optimal oral hygiene.

Professional treatment is still needed

While Waterpik can help reduce mild to moderate gum disease, advanced cases will still require professional treatment. Here are some reasons why additional care is vital:

  • Only a dentist or hygienist can accurately assess disease state and pocket depths.
  • Deep cleanings are required to thoroughly debride hardened calculus deposits.
  • Ongoing periodontal maintenance is key to stopping disease progression.
  • Medications like antibiotics may be prescribed to resolve infection.
  • Surgery is sometimes needed to treat bone loss and deep pockets.
  • Dentists track results and adjust treatment based on follow-up exams.

Waterpik usage cannot take the place of examinations, cleanings, and procedures performed at the dental office. Ongoing professional treatment is essential for advanced periodontal disease.

Tips for effective Waterpik use

To get the most gum health benefits from Waterpik use, dental professionals recommend:

  • Using the correct tip – plaque control tips target hard-to-reach places.
  • Adjusting the pressure between 45-75 PSI for optimal cleansing.
  • Aiming the stream at a 90-degree angle into periodontal pockets.
  • Starting in the back and working toward the front teeth methodically.
  • Spending at least 30 seconds water flossing per quadrant of the mouth.
  • Water flossing after meals to help prevent plaque buildup.

Proper technique is important to irrigate effectively under the gums. The Waterpik should be used as a cleaning aid, not just a quick water rinse. Consistency is key for establishing long-term improvements in oral health.

The takeaway

When used properly as part of a comprehensive oral care routine, Waterpik can provide complementary benefits for gum health:

  • Removes disease-causing plaque bacteria in hard to reach areas
  • Reduces inflammation and improves gum pocket health
  • Enhances the effectiveness of brushing and flossing

The research shows Waterpik oral irrigation is an effective tool to help reverse early stages of periodontal disease. For mild to moderate cases, using Waterpik as directed may help restore gums to a healthy state. However, Waterpik cannot treat advanced disease without professional care. Periodontal disease requires an integrated approach combining thorough at-home oral hygiene and ongoing professional treatment and maintenance. For optimal results, Waterpik should be used under the guidance of a dental professional as part of a customized treatment plan based on each patient’s specific needs and disease state.


In summary, Waterpik can provide measurable benefits for improving gum health and potentially reversing early periodontal disease. However, oral irrigation is not a magic cure-all by itself. The device needs to be used properly and as part of a daily oral care routine also including brushing and flossing. For moderate or advanced disease, professional dental treatment is still required. When used as intended under dental guidance, Waterpik can be a useful supplementary tool for managing and turning around periodontal disease in its early stages. But for more significant disease, professional intervention remains essential for stopping progression. For anyone concerned about gum disease, the best approach is to see a dentist for an exam and follow their recommendations for optimal at-home cleansing, which may include Waterpik oral irrigation.