The Fell Sulcular Sweep Provides an Innovative Interdental Cleaning Technique

The Fell Sulcular Sweep (FSS) is an interdental cleaning technique designed to more effectively disrupt and remove biofilm in the sulcus and interproximal spaces, areas where traditional brushing and flossing often fall short. Developed by William Fell, DDS, who treated patients in Anchorage, Alaska, for 48 years, the technique emphasizes sweeping motions that target both the tooth surface and the gingival sulcus, helping to improve periodontal health.

Dr. Fell shared his motivation for creating the FSS with Sunstar Ebrief, “My desire to create something new and more effective came from my patients who were doing the standard oral hygiene regimen but still showing symptoms of active periodontitis and recurring decay.”

As he sees it, plaque is not naturally pathogenic, but when left on the tooth too long and in too high of concentrations, the plaque becomes pathogenic. And simple carbohydrates are the culprit.

“While treating patients in the Village of Kipnuk on the west coast of Alaska, I found some older patients with thick plaque over their teeth and a complete set of properly aligned teeth and no periodontitis or decay. They were on traditional diets of little if any refined carbohydrates.

With this understanding I concluded that displacing the food from between and around the teeth after every eating episode was essential. Bacteria don’t sleep when near a food source, so food should not be left for any amount of time in contact with the bacteria.”

He also studied the architecture of the depression in the gingival tissue between the teeth, located below the floss line, known as the Col. This area has been largely overlooked by all self-care methods, according to Dr. Fell. Neither flossing nor brushing effectively disrupts the organized bacterial mass within the Col, particularly when pocket depths exceed 3 to 4 mm. The FSS technique is designed to address this critical gap in oral care.

Unlike conventional flossing, the FSS uses specially designed ultra-thin interdental brushes, such as GUM Soft-Picks, or tailored devices that are positioned at the gingival margin.

“I needed a patient-friendly tool to displace trapped food and bacterial biomass to the depths of the Col from the facial to the lingual aspect of the Col,” explained Dr. Fell.

“I discovered a plastic pick with a tip not much greater than 1mm in width at the tip as sulcus width at the floor provides the best access.”

The motion of the pick involves a gentle yet deliberate sweep along the tooth’s sulcular area, extending slightly below the gumline and across the interproximal space. This approach maximizes contact with the biofilm, ensuring its mechanical disruption.

FSS may improve outcomes in patients with gingivitis, periodontal inflammation, and those at higher risk of biofilm-related oral disease. The technique is especially advantageous for individuals with orthodontic appliances, dental implants, or restorations, as it can navigate irregular surfaces more effectively than traditional floss.

One of the main benefits of the Fell Sulcular Sweep is patient compliance. Many individuals struggle with flossing due to dexterity challenges or discomfort, which limits its long-term effectiveness. The FSS, however, is easier to master, often requiring less time and effort while providing a more thorough clean. This has made it an appealing recommendation for dental hygienists and periodontists seeking alternatives to conventional interdental cleaning.

“I have never had a patient say the concept didn’t work, but it does involve dedication on the patient’s and caregiver’s part in reinforcing the need to adhere to its daily use,” Dr. Fell noted.