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Research ArticleResearch in Oral Health

Efficacy of water flossing on clinical parameters of inflammation and plaque: A four-week randomized controlled trial

Deborah Mancinelli-Lyle, Jimmy G. Qaqish, C. Ram Goyal and Reinhard Schuller
American Dental Hygienists' Association October 2023, 97 (5) 166-186;
Deborah Mancinelli-Lyle
Department of Periodontology, Academic Center for Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, NL
RDH, BS, MS
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  • For correspondence: [email protected]
Jimmy G. Qaqish
All Sum Research Center, Ltd., Mississauga, Ontario, CA
BSc
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C. Ram Goyal
All Sum Research Center, Ltd., Mississauga, Ontario, CA
BDS
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Reinhard Schuller
Reinhard Schuller Consulting, Toronto, Ontario, CA
MSc
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Abstract

Purpose The primary prevention of periodontitis is controlling gingivitis daily. The study objective was to compare the efficacy of a pulsating water flosser to a pulsating water flosser infused with air microbubbles on clinical signs of inflammation and plaque.

Methods One hundred and five participants were enrolled in this single-blind, single-center, parallel, four-week, IRB/IEC-approved clinical trial. Participants were randomly assigned to one of three groups: water flosser (WF) plus manual toothbrush, water flosser infused with microbubbles of air (MBWF) plus manual toothbrush, or dental floss (DF) plus manual toothbrush. Bleeding on probing (BOP), Modified Gingival Index (MGI), and Rustogi Modification Navy Plaque Index (RMNPI) scores were recorded at baseline, 2-weeks, and 4-weeks.

Results All participants completed the study (n=105). All groups showed a statistically significant reduction for BOP, MGI, and RMNPI at 4-weeks (p<0.05, except DF marginal RMNPI). The WF group showed a statistically significant greater reduction in whole mouth BOP (0.41) compared to MBWF (0.32) and DF (0.19). This was also true for MGI (0.37, 0.30, and 0.20, respectively) and RMNPI (0.13, 0.11, and 0.06, respectively) (p<0.05 for all comparisons). No adverse events were reported.

Conclusion This study demonstrates that a manual toothbrush and water flosser, with or without microbubbles, is an effective oral care regimen for controlling gingivitis over four weeks.

Keywords
  • water flosser
  • oral irrigator
  • dental floss
  • gingivitis
  • oral health
  • gingival bleeding
  • Received April 28, 2023.
  • Accepted September 12, 2023.
  • Copyright © 2023 The American Dental Hygienists’ Association
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American Dental Hygienists' Association: 97 (5)
American Dental Hygienists' Association
Vol. 97, Issue 5
October 2023
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Efficacy of water flossing on clinical parameters of inflammation and plaque: A four-week randomized controlled trial
Deborah Mancinelli-Lyle, Jimmy G. Qaqish, C. Ram Goyal, Reinhard Schuller
American Dental Hygienists' Association Oct 2023, 97 (5) 166-186;

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Efficacy of water flossing on clinical parameters of inflammation and plaque: A four-week randomized controlled trial
Deborah Mancinelli-Lyle, Jimmy G. Qaqish, C. Ram Goyal, Reinhard Schuller
American Dental Hygienists' Association Oct 2023, 97 (5) 166-186;
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  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSION
    • ACKNOWLEDGEMENTS
    • Appendix S1. Instructions for brushing (all groups) and flossing
    • Appendix S2. Schematic illustration of information provided to the participants
    • Appendix S3. Study schedule from baseline to 4-weeks
    • Appendix S4. Products used in study
    • Appendix S5. Indices for measurement of gingival bleeding, inflammation, and plaque
    • Appendix S6. Mean change scores from baseline to 2-weeksa
    • Appendix S7. Mean change scores for subareas from baseline to 4-weeksa
    • Appendix S8. Mean percent reductions from baseline and comparisons between groups at 4-weeksa
    • Footnotes
    • REFERENCES
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Keywords

  • water flosser
  • oral irrigator
  • dental floss
  • gingivitis
  • oral health
  • gingival bleeding

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