A Water Pick can be a helpful aid in oral hygiene. For orthodontic patients who have braces, it can be a big help to flush food particles that are trapped in the little nooks and crannies under the wires and brackets. For periodontal patients (those with advanced gum disease), it can be helpful to deliver chemotherapeutic agents deep into the pockets between the teeth and gums where the bone has been destroyed by the disease. It is important to not use the Water Pick at a high setting in order to avoid stripping away the gingival attachment (the portion that connects the gums to the teeth). Although a Water Pick can be a good adjunct, it is not a full alternative to using a toothbrush and floss. Plaque is formed by bacteria which converts sugar into a sticky substance. With the bacteria stuck to the teeth, they are free to form acids and toxins which are the cause of decay and gum disease. A Water Pick is not strong enough to clean the sticky plaque off the tooth surfaces, therefore, a brush and floss must be used.