When regular brushing cleans 60% of the tooth surfaces, it goes without saying that there is a need to use something to clean that remaining 40%.
Your options include floss or interdental brushes. But, there are the powered options such as water flossers and air floss units.
Waterpik water flossers and Sonicare Airfloss are the best known examples, but which is better?
The short answer is Waterpik.
Clinically proven and with a bigger and more diverse range, they are the top choice.
However, Philips Airfloss is still beneficial and is the more convenient tool to use on a daily basis for most people.
Waterpik -- A brand of water flossers
Waterpik are a US-based company that dominate within the water flosser market.
They are not the only brand who make water flossers, but given the number of products they produce and their research they are the best.
Several of their products appear in our list of Best Water Flossers, whilst also taking the number 1 spot.
They are what Coca Cola is to the Cola market. As a result, their name has become synonymous with water flossers and their company/brand name is used interchangeably to describe such, when technically they are different.
For the remainder of this article I too will use the brand name Waterpik interchangeably with the term water flosser.
Cordless and countertop water flossers
Water flossers are offered in 2 different styles.
You have both countertop and cordless options to choose from.
As the names imply, the cordless option is cable free and tends to be powered by a built in rechargeable or user replaceable battery. By its very nature it is smaller and portable.
A countertop flosser is larger, more powerful, more capable and relies typically on being plugged into the mains to operate.
Sonicare Airfloss -- A product
Not necessarily exclusive to, but pioneered by Philips Sonicare, is the Airfloss.
As such, like Waterpik, Sonicare has become well known for Airfloss products.
Whilst the aims of Airfloss are similar to a water flosser, the way in which they work are different.
At the time of writing, Airfloss products are designed to be cordless and portable.
Airfloss vs water flossing (Waterpik) -- the same aim, 2 different approaches
What fundamentally separates these 2 products is the approach to cleaning the interdental spaces.
Waterpik uses a stream of water, delivered at a constant pressure.
Sonicare AirFloss uses bursts of air, interspersed with small micro droplets of water, or microbursts as Sonicare call it.
2 different approaches, both aim to tackle the same problem of plaque removal and aid with interdental cleaning or flossing as most of us know it as.
You can consider them as alternative tools to floss and interdental brushes.
Traditional string floss or tape that you might use can be fiddly, awkward and uncomfortable to use. This can put you and me off from cleaning away plaque from between the teeth.
How to use
The 2 different approaches to cleaning mean the way in which you use the Waterpik and Sonicare Airfloss are slightly different.
With the Airfloss you move the tip of the nozzle to the interdental space you want to clean, press the button, the jet of air and water is delivered into the gap. You then move it to the next gap and repeat the process until you have cleaned the whole mouth.
With a water flosser the stream of water is normally continuous. Whilst you move from one interdental space to another, there is a need to be more controlled and focused with your approach, following the gumline as you go.
How you use either are best demonstrated in the following promotional videos.
Advantages and disadvantages
The fact that these 2 products are powered by electricity does bring some significant benefits, most notably you have to apply less effort than string floss.
But there are certainly some negatives as well as positives.
They are in my opinion, as follows.
- Effectiveness -- Nothing matches how well they clean with so little effort.
- Pressure settings -- Variable pressure settings put you in control of just how powerful the jet of water fired from the nozzle is.
- Dislodges bigger particles -- The higher power and greater volume of water is better able to dislodge larger particles of food that may be left behind after eating.
- Cordless and countertop -- Choice comes in the form of cabled and cable free water flossers, so you can have one most suitable for you.
- Control -- Long nozzles with angled tips and the ability to rotate the tips a full 360 degrees gives unrivalled control over just where the jet hits and cleans.
- Different nozzles -- Differently designed nozzle tips offer different cleaning experiences for different user based on needs. The simple clip in and out configuration makes nozzle changing fast and practical in a family environment.
- Messy -- The constant stream of water can seem too much and takes some practice to position the lips and learn how to move and control the tips for the best results. All too easily initially to spray the bathroom with water.
- Size -- Both the cordless and countertop units are bigger and heavier than the Airfloss and take up more space.
- Portability -- As a consequence of their design they are not all that portable.
- Time -- It can take longer to clean with a water flosser.
- Reservoir sizes -- The different reservoir sizes on cordless and countertop units can mean you may or may not have enough water in the tank not to have to refill to complete the clean.
- Less messy -- Each burst contains a tiny amount of water, making it perfectly possible to complete a clean, yet retain the water within the mouth without needing to spit it out until the end.
- Cordless -- Not restricted by wires you can move around and use wherever you wish.
- Convenience -- The size, shape and ease of use make it a very convenient product to use on a daily basis.
- Battery life -- The built in rechargeable battery lasts about 2 weeks between charges.
- Automatic power off -- A simple but neat feature, it will automatically power off after 4 minutes, which save you having to turn it off and is more than enough time to do what you need to.
- Charging stand -- Uses the same charger as Sonicare electric toothbrushes, meaning you can interchange the Airfloss and your toothbrush with the same charging stand if you use a Sonicare electric toothbrush.
- Pressure control -- There is little or no control (subject to model) over the force at which the jet of air and water is fired at.
- Reservoir size –A little on the small side, extra capacity would be preferred for longer usage time between refills.
- Difficult to share -- The nozzles are replaceable but do not interchange with as much ease or offer storage locations like many Waterpik options.
A word on cost
Price can be a determining factor as to whether or not you buy a product.
I do believe it should be considered as part of your decision making process, but where possible avoid letting it be a primary factor.
It is more important to get the product that works for you.
The price of a Waterpik or an Airfloss will differ depending on which model you are looking at, where and when you are buying it too.
You can get some very cost effective water flossers for £30 but you can easily pay up to £100.
The Airfloss tends to be fairly consistently priced at around £50-100 subject to model.
Due to the different models and features and the fact that they are 2 different products with different approaches, comparing on price alone is not always fair.
As a general rule, you can get better value from water flossers, particularly countertop as opposed to Airfloss.
Which is better -- the clinical studies
The statistics that have been gathered under clinical trial clearly show that the Waterpik water flossers are more effective than Airfloss, in a number of ways.
The studies have shown that plaque removal and the reduction in bleeding at the gumline were better when using Waterpik.
Clinically significant and a foundation for the recommendations dentists make today comes from an independent study by BioSci Research Canada, completed in 2012.
Comparing the Sonicare Airfloss and a Waterpik Water flosser, the study focused purely on plaque removal and found that the reduction in plaque after use of each of these tools were 74.9% for Waterpik and 57.5% for Airfloss.
With a 17% difference in favour of Waterpik, the effectiveness of the water flosser is quite profound.
This difference continues when analysing specific areas of the mouth.
- Marginal -- 58.6% vs 36.7%
- Approximal -- 92.1% vs 77.4%
- Facial -- 83.6% vs.69.1%
- Lingual -- 65.7% vs 45.4%
The Waterpik achieved greater plaque reduction in all 4 areas.
Another example of where Airfloss loses out to Waterpik is a 2015 study by Goyal and team. It specifically looked at the reduction of bleeding, gingivitis and plaque over a 4 week period.
54% more effective was the water flosser for reducing bleeding and 32% for reducing gingivitis compared to the Airfloss Pro at 4 weeks. The Water Flosser was also 28% more effective for reducing plaque compared to the Airfloss Pro.
Waterpik have helped fund many research projects that assess and compare water flossers in many different ways to show the power and capability in removing plaque and helping with oral health.
Daily use -- sensitive/bleeding gums/orthodontics
Whilst there is no question over just how well the Waterpik can remove plaque from the teeth, when it comes down to day to day usage, the feeling and sensation can be quite different.
I have listed what I believe to be the pros and cons of both, earlier in this article. However, I wish to give a bit of extra context and understanding from my personal experiences.
Busy lifestyles often lead us to look for the most convenient option. String flossing tends not to be associated with the word convenience, most likely inconvenience.
For me, this is where the Airfloss really comes in. You should still use regular flossing approaches with either appliance, but if you are short of time and the alternative is not to floss at all the 30-60 seconds of use with the Airfloss is much better than nothing.
Compared to the water flosser, it feels much quicker to complete the clean, with a lot less effort.
Airfloss uses a tiny fraction of the water compared to a water flosser and as such, the smaller volume of water used, means you can retain that in your mouth until you complete the clean, then spit it out once you are done. You can easily stand in front of the mirror to help with alignment and aiming the nozzle, without fear of spraying the mirror, not quite the case with a water flosser.
The approach requires you to be lent over a sink to rid your mouth of the excess water. Even having a cordless option does not exactly stop this, you are just not attached by a hose.
Some models of Waterpik have a button on the handle that can easily control the flow, stopping and starting it with more ease, but position the flosser or the lips wrongly and the jet can quickly spray across the bathroom.
Of course a big benefit of the cordless option is that they are much more convenient for travel, if a bit bulky compared to Airfloss.
Unless well practiced, the water tanks on the cordless units can be considered too small. You can clean the gumline in the 45 seconds or so you get from the tank, but it does not always feel as thorough as when you spend a little longer with a countertop unit that has a longer cleaning time.
There is no denying that using the Waterpik units are much better for those with sensitive teeth and gums, inflamed or bleeding gums as well as those with braces and health issues like periodontal pockets.
The flow of water, variable pressure controls and interchangeable nozzles are much more versatile and better suited to specific needs.
Unless opting for the Pro version of the Airfloss you have a list less control over the amount of force at which the microburst is delivered at. Waterpiks have up to 10 levels of pressure settings for much more granular control.
Inflamed or bleeding gums can be very sensitive and the Airfloss can feel much harsher, with a higher likelihood of the gums bleeding when used.
With the water flosser, the flow of water will stimulate good gum health and will be more enjoyable to use and help reduce bleeding and inflammation with less pain.
Suitable particularly for those with more specialised dental health needs, the likes of the Orthodontic and Pik Pocket tips help those with particular dental health requirements in a way that Airfloss cannot.
Whilst both have proven their worth, the water flosser is certainly for those most serious about oral health.
Airfloss is a much more convenient and appealing option for most average people though. In my mind, it fits into the lifestyle of those who would never floss, but know they should, an opinion backed by dental hygienist Karen Davies “The engineers at the Philips Corporations specifically developed AirFloss to help bridge the gap for patients that need to floss, but don’t.”
What about normal flossing -- What do dental professional say
Whilst it is not possible to speak for all dental professionals, the words of Anna — or as she is better known as London Hygienist — I feel sum up the view of most:
While neither are considered gold standard for interdental cleaning, they do serve as a fantastic adjunct to a good oral hygiene routine. They are great for removing plaque and food debris from around crowns, implants, bridges and hard to reach areas. They can be useful for those with orthodontics, manual dexterity and sight difficulties as well as those “can’t floss, won’t floss” patients. It is still recommended though to clean in between the teeth daily with floss or interdental brushes.
Anna Middleton -- The London Hygienist -- GDC Number: 231205
Clinical research does exist, but is still fairly limited to conclusively show that these powered flossers have significant advantage over the tried and tested string floss.
The most recent study, in 2017 by Mwtha and team found that AirflossPro provides a similar reduction in gingivitis and plaque to string floss.
As I have shown earlier in this article, there is evidence to show that both are effective at plaque removal.
String floss has for a long time been a recommendation of dentists and the NHS.
What power flossers fail to replicate is the physical act of passing over the tooth surface like string floss or interdental brushes do to dislodge and lift away the potentially harmful buildup.
Despite many years of recommendation, the reality is that too few people clean interdentally.
Irrespective of the facts, it’s about finding tools that encourage interdental cleaning, as something is better than nothing.
89% of patients surveyed in the USA, found that flossing with Airfloss was easier than string floss, a statistic I can agree with.
Waterpiks, Airfloss, string floss and interdental brushes are all tools to help clean those surfaces of the teeth that regular brushing simply does not reach.
My opinion as well as the results of clinical trials are all well and good, but what are the dental professionals that have daily contact with patients saying?
Dr Angely Ly demonstrates the cleaning power of Sonicare Airfloss in her hands on video, but advocates that it is used in addition to regular floss, to complement and improve your cleaning, just like London Hygienist.
Dentist Barry Gibberman recommends both.
The team at Somerset Dental agree with my view of finding the right tool and say,
“It’s important to identify which one you would actually use on a regular basis as well as which method would be right for you based on your needs.”
Dentist Scott Frey of Frey Smiles is personally not a big fan of Airfloss, but says,
“If it gets people who aren’t flossing at all to clean between their teeth something is better than nothing”
In-house dentist Dr Gemma Wheeler also has some reservations, explaining:
A water flosser or air flosser will work ok in patients who have healthy gums or mild gum disease. For advanced gum disease, I always recommend interdental brushes as the most effective way to remove the disease-causing bacteria.
Dr Gemma Wheeler -- In-house dentist -- GDC Number: 259369
The Sonicare Airfloss range is limited in comparison to Waterpik water flossers, but that makes your purchasing decision easier.
There are 2 main versions of the Philips Sonicare AirFloss. There is the standard version and a newer ‘Pro’ version.
If you were to be shown an image (as above) of the two they look similar, with the exception of the nozzle colour, however there are a few more differences, and they are:
- The AirFloss Pro has a larger reservoir for water or mouthwash
- The AirFloss Pro is psychically larger
- The AirFloss Pro offers different burst modes, automatic, manual, single, double or triple, compared to manual or automatic of the standard AirFloss
- The Pro has a different nozzle attachment (the nozzles are not interchangeable between the two models)
- The AirFloss (non pro) delivers more pressure
- The Pro model is more expensive (correct at time of writing)
The standard Airfloss comes in 2 colours:
- Green and white -- model number HX8211/02
- Pink and white -- model number of HX8222/02
The Airfloss Pro comes in 3 color options:
- White with grey accents -- model number of HX8472/11
- Black -- model number of HX8432/23
- Pink -- model number of HX8432/12
An additional accessory that works with both models is the Sonicare Airfloss fill and charge station.
This makes the portable Airfloss feel a bit more like a Waterpik.
The unit remoans portable, but when not in use, it can be docked within this station, that recharges the unit, but also automatically refills the reservoir on the Airfloss, from the larger reservoir that is part of the fill and charge station.
What this means is you need to only think about refilling the charge station every few weeks or so compared to every day without it.
It does come at a price though and will be difficult to justify for most.
At the time of writing there are 10 different water flossers available from Waterpik. That does not include the different coloured units. 3 of these are cordless.
Each of these have their own pros and cons. Some have more or less features, bigger or smaller tanks, more or less in the box. Many we have gone hands on with and reviewed.
However, you probably want to know which are the best to go for.
The best countertop option is the Waterpik WP-660 and, perhaps unsurprisingly, it is also the winner of our roundup of the best water flossers.
It is the standard to beat. It offers all the desirable features.
- A 90 second run time
- Built in timer/pacer
- Water control button on the handle
- 10 pressure settings
- 7 tips included in the box
- A slimmer profile than many other models
- Quieter than other models too
The Aquarius is a great balance between features, size and price.
It does to come in a range of colours, so you need not be stuck with the standard white colour option.
The best cordless options is the Waterpik WF-03.
Powered by user removable AA batteries you don’t need to worry about mains power with this unit.
It is a bit bulkier and perhaps not as friendly for those who like to pack light.
But boasting a large tank, different pressure settings, interchangeable tips these are compromises potentially worth disregarding given the benefits.
The box contents is good with 2 classic jet tips and an orthodontic tip included.
A travel pouch and even a travel plug are also provided.
Conclusion -- which should I choose?
Only you can make a decision as to which is right for you.
From my perspective, the Sonicare wins hands down for sheer convenience and simplicity. If you are failing to floss regularly, but know you need to make improvements then this can be very helpful in achieving that.
However, the best results do come from opting for Waterpik.
The clinical trials speak for themselves in just how good they are when plaque removal and overall improved oral health is the aim, there is a lot of good reason to opt for Waterpik.
Just remember, if you can, do try to carry out regular flossing too.