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Research ArticleResearch
Open Access

Efficacy of Flossing and Mouthrinsing Regimens on Plaque and Gingivitis: A randomized clinical trial

Mary Lynn Bosma, James A. McGuire, Anusha Sunkara, Pamela Sullivan, Abbie Yoder, Jeffery Milleman and Kimberly Milleman
American Dental Hygienists' Association June 2022, 96 (3) 8-20;
Mary Lynn Bosma
Johnson & Johnson Consumer Inc., Skillman, NJ, USA.
RDH, DDS
Roles: Director of Claims Strategy
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  • For correspondence: mbosma{at}its.jnj.com
James A. McGuire
Johnson & Johnson Consumer Inc., Skillman, NJ, USA.
MS
Roles: Director of Global Biostatistics
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Anusha Sunkara
Johnson & Johnson Consumer Inc., Skillman, NJ, USA.
MS
Roles: Principal Biostatistician, Global Biostatistics
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Pamela Sullivan
Johnson & Johnson Consumer Inc., Skillman, NJ, USA.
BSDH
Roles: Manager of Clinical Research
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Abbie Yoder
Salus Research, Inc., Fort Wayne, IN, USA.
BS
Roles: Study Coordinator
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Jeffery Milleman
Salus Research, Inc., Fort Wayne, IN, USA.
DDS, MPA
Roles: Director of Clinical Operations and Principal Investigator
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Kimberly Milleman
Salus Research, Inc., Fort Wayne, IN, USA.
RDH, MS, PhD
Roles: Director and Compliance Specialist
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This article has a correction. Please see:

  • Correction to Bosma, ML, et al. (2022) - October 01, 2022

Abstract

Purpose: Flossing is a well-known component of daily recommended oral care regimens, but patients often find it challenging to perform effectively on a regular basis. The purpose of this 12-week supervised clinical trial was to investigate the effects of twice daily rinsing with a mouthrinse containing a fixed combination of four essential oils (4EO) and supervised daily dental flossing regimens as compared to a negative control 5% hydroalcohol rinse (NC) on the prevention and reduction of plaque, gingivitis, and gingival bleeding.

Methods: Volunteer participants who met the inclusion criteria were randomized into the following groups for the 12-week trial: 1) NC; 2) mouthrinse containing 4EO; 3) professional flossing performed by a dental hygienist (FBH); 4) supervised self-flossing (FUS). All participants received a professional dental prophylaxis prior to beginning the trial. On weekday mornings, all participants brushed on site. After brushing, the rinse groups used their products under supervision, and the floss groups had their teeth flossed by a dental hygienist or self-flossed under supervision. Participants performed their assigned regimen in the evenings and the twice-daily weekend use at home. Each individual assessment of oral hard and soft tissue, plaque, gingivitis, and gingival bleeding at weeks 4 and 12, probing depth and bleeding on probing at week 12 was made by the same calibrated examiner.

Results: Of 156 randomized participants, 149 completed the trial. Use of the 4EO mouthrinse statistically significantly reduced plaque, gingivitis, and gingival bleeding on probing after 12 weeks as compared to the NC rinse. Both flossing interventions statistically significantly reduced interproximal gingivitis and gingival bleeding at 12 weeks compared to the NC rinse; neither flossing intervention significantly reduced interproximal plaque after 12 weeks compared to the NC rinse.

Conclusions: Rinsing with a 4EO mouthrinse statistically significantly improved all oral health outcome measures at all time points compared to a NC rinse in this 12-week clinical trial. While professional and supervised flossing improved gingival health compared to use of the NC rinse, statistically significant plaque reduction with dental flossing was not attained at the end of the 12-week trial.

  • dental plaque
  • gingivitis
  • essential oils
  • mouthrinse
  • chemotherapeutics
  • dental floss
  • oral health

Footnotes

  • This manuscript supports the NDHRA priority area, Client level: oral health care (new therapies and prevention modalities).

  • Disclosures

    Johnson & Johnson Consumer Inc., (JJCI; Skillman, NJ, USA) sponsored this clinical trial and was responsible for the trial design and the collection, analysis, and interpretation of the data. Mary Lynn Bosma, James McGuire, Anusha Sunkara, and Pamela Sullivan are employees of JJCI. Jeffery Milleman and Kimberly Milleman are principals at Salus Research, Inc, Fort Wayne, IN, USA and received grants from JJCI and conducted the trial on behalf of JJCI. Abbie Yoder is an employee of Salus Research, Inc.

  • Received February 28, 2022.
  • Accepted April 29, 2022.
  • Copyright © 2022 The American Dental Hygienists’ Association

This article is open access and may not be copied, distributed, or modified without written permission from the American Dental Hygienists’ Association.

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Efficacy of Flossing and Mouthrinsing Regimens on Plaque and Gingivitis: A randomized clinical trial
Mary Lynn Bosma, James A. McGuire, Anusha Sunkara, Pamela Sullivan, Abbie Yoder, Jeffery Milleman, Kimberly Milleman
American Dental Hygienists' Association Jun 2022, 96 (3) 8-20;

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Efficacy of Flossing and Mouthrinsing Regimens on Plaque and Gingivitis: A randomized clinical trial
Mary Lynn Bosma, James A. McGuire, Anusha Sunkara, Pamela Sullivan, Abbie Yoder, Jeffery Milleman, Kimberly Milleman
American Dental Hygienists' Association Jun 2022, 96 (3) 8-20;
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  • Correction to Bosma, ML, et al. (2022)
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Keywords

  • dental plaque
  • gingivitis
  • essential oils
  • mouthrinse
  • chemotherapeutics
  • dental floss
  • oral health

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