PROBLEM STATEMENT: Interdental cleaning is essential for preventing gingivitis and periodontitis. Dental floss is often the most recommended tool for interdental cleaning; yet only one-third of adults report flossing daily. Moreover, many cannot floss at a level to achieve an oral health benefit. Water flossers are an easy and effective alternative to string floss for improving oral health. Recently, a variety of water flosser tip configurations have entered the market. This study seeks to determine if one type of tip is better for daily water flossing.
PURPOSE: The purpose of this study was to compare the effectiveness of a manual toothbrush plus a water flosser with a precision jet tip to a manual toothbrush plus a power (water) flosser with a novel, four-stream tip on the reduction of bleeding, gingivitis, and plaque.
METHODS: This was a parallel, single-blind, 4-week clinical trial. Seventy subjects were randomized into one of two groups: a water flosser with a precision jet tip plus a manual toothbrush or a power (water) flosser (WFS) with a novel, four-stream tip plus a manual toothbrush (PFM). Bleeding on probing (BOP), Modified Gingival Index (MGI), and Rustogi Modification Navy Plaque Index (RMNPI) scores were recorded at baseline, 2 and 4 weeks. Statistical analysis included paired t-tests, two-treatment ANOVA, Wilcoxon and Fisher's Exact Test.
RESULTS: All participants completed the study. Both groups showed a statistically significant improvement for BOP, MGI, and RMNPI at 4-weeks (p < 0.001). The WFS showed a statistically significant greater reduction in BOP versus the PFM, 0.40 (72.6%) versus 0.32 (57.8%) respectively. Additionally, 80% of the subjects using the precision jet tip achieved at least a 70% reduction in BOP versus 6% of those using the novel, four-stream tip. For MGI and RMNPI, the precision tip was also more effective; MGI was 17.5% versus 14.3%, and RMNPI was 18% versus 14.9%. No adverse events were reported or observed.
CONCLUSION: The precision jet tip was significantly more effective than a novel, four-stream tip at reducing bleeding, gingivitis, and plaque.
IRB approval number: 2023-WP-2
This study supports the ADHA National Dental Hygiene Research Agenda: Client Level/Oral Health Care/Health Promotion: treatments, behaviors, products and the NIDCR Strategic Plan 2021-2026: Strategic Priority #3; Translate and Implement: Preventive, diagnostic and treatment practices proven to improve oral health outcomes for individuals and communities as well as evidence-based patient-centered dental hygiene practice.
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