Efficacy of a water flosser compared to an interdental brush on gingival bleeding and gingival abrasion: A 4 week randomized controlled trial

Deborah Mancinelli-Lyle; Fridus Van der Weijden; Dagmar E. Slot

doi:10.1111/idh.12817

Efficacy of a water flosser compared to an interdental brush on gingival bleeding and gingival abrasion: A 4 week randomized controlled trial

Deborah Mancinelli-Lyle
, Fridus Van der Weijden
, Dagmar E. Slot^*

^*Corresponding author for this work

Periodontology

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Aim: To determine the efficacy of a water flosser (WF) compared to an interdental brush (IDB) in reducing gingival inflammation. Additionally, the products were compared on the incidence of gingival abrasion.

Methods: Young adults with moderate gingivitis and ≥4 accessible interdental spaces by IDB in each quadrant were selected for this study. Participants were randomly assigned a WF or an IDB as an adjunct to manual toothbrushing. Clinical signs of inflammation were measured in two randomly assigned contralateral quadrants by bleeding on pocket probing (BOPP) or bleeding on marginal probing (BOMP). Gingival Abrasion Score (GAS) was assessed per quadrant. Data was recorded at the baseline, 2 weeks and 4 weeks.

Results: Both groups WF (n = 40) and IDB (n = 38) showed a significant reduction (p = 0.000) in BOMP and BOPP from the baseline to 4 weeks for all sites and the interdental sites only. At 4 weeks the WF group compared to the IDB group showed significantly lower BOPP (p = 0.030) and BOMP scores (p = 0.003) for all sites. For the interdental sites WF showed compared to IDB for BOMP significant (p = 0.019) lower values but not for BOPP (p = 0.219). There were no differences between the groups for GAS at any time point.

Conclusion: In patients with moderate gingivitis, after 4 weeks use the WF is more effective than the IDB in obtaining marginal gingival health.

Original language	English
Pages (from-to)	176-185
Number of pages	10
Journal	International Journal of Dental Hygiene
Volume	23
Issue number	1
Early online date	12 Jul 2024
DOIs	https://doi.org/10.1111/idh.12817
Publication status	Published - Feb 2025

Bibliographical note

Publisher Copyright:
© 2024 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.

Funding

The first author, Mancinelli‐Lyle, was an employee of Water Pik, Inc. when the study was conducted. Van der Weijden is the owner of Jardin B.V., which is the former owner of www.ragershop.com (a webshop for various brands of interdental brushes). The study was performed by the Department of Periodontology of ACTA with a commission from ACTA Dental Research B.V. In turn ACTA Research B.V. received financial support from Water Pik, Inc. Fort Collins, CO. USA, Water Pik, Inc. Fort Collins, CO. USA provided the study products. The research team at ACTA of Slot and van der Weijden has previously received either external advisor fees, lecturer fees or research grants from oral health care manufacturers. Those manufacturers included Colgate, Dentaid, GABA, Lactona, Oral‐B, Philips, Procter & Gamble, Sara Lee, Sunstar, TePe,Unilever & Water Pik. The authors thank the dental hygienists Nienke Hennequin-Hoenderdos (NLHH), Eveline van der Sluijs (EvdS), Paula Kegel-Versteeg (PAV) and Sam Supranoto (SS), for coordination, medical ethics approval procedures, and performing the clinical assessments during the study.

Funders
Water Pik, Inc.
Eveline van der Sluijs
Sam Supranoto

Keywords

gingival abrasion
gingival bleeding
gingivitis
interdental brush
oral irrigator
water flosser

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title = "Efficacy of a water flosser compared to an interdental brush on gingival bleeding and gingival abrasion: A 4 week randomized controlled trial",

abstract = "Aim: To determine the efficacy of a water flosser (WF) compared to an interdental brush (IDB) in reducing gingival inflammation. Additionally, the products were compared on the incidence of gingival abrasion.Methods: Young adults with moderate gingivitis and ≥4 accessible interdental spaces by IDB in each quadrant were selected for this study. Participants were randomly assigned a WF or an IDB as an adjunct to manual toothbrushing. Clinical signs of inflammation were measured in two randomly assigned contralateral quadrants by bleeding on pocket probing (BOPP) or bleeding on marginal probing (BOMP). Gingival Abrasion Score (GAS) was assessed per quadrant. Data was recorded at the baseline, 2 weeks and 4 weeks.Results: Both groups WF (n = 40) and IDB (n = 38) showed a significant reduction (p = 0.000) in BOMP and BOPP from the baseline to 4 weeks for all sites and the interdental sites only. At 4 weeks the WF group compared to the IDB group showed significantly lower BOPP (p = 0.030) and BOMP scores (p = 0.003) for all sites. For the interdental sites WF showed compared to IDB for BOMP significant (p = 0.019) lower values but not for BOPP (p = 0.219). There were no differences between the groups for GAS at any time point.Conclusion: In patients with moderate gingivitis, after 4 weeks use the WF is more effective than the IDB in obtaining marginal gingival health.",

keywords = "gingival abrasion, gingival bleeding, gingivitis, interdental brush, oral irrigator, water flosser",

author = "Deborah Mancinelli-Lyle and Fridus Van der Weijden and Slot, \{Dagmar E.\}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. International Journal of Dental Hygiene published by John Wiley \& Sons Ltd.",

year = "2025",

month = feb,

doi = "10.1111/idh.12817",

language = "English",

volume = "23",

pages = "176--185",

journal = "International Journal of Dental Hygiene",

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Efficacy of a water flosser compared to an interdental brush on gingival bleeding and gingival abrasion: A 4 week randomized controlled trial. / Mancinelli-Lyle, Deborah; Van der Weijden, Fridus ; Slot, Dagmar E.
In: International Journal of Dental Hygiene, Vol. 23, No. 1, 02.2025, p. 176-185.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Efficacy of a water flosser compared to an interdental brush on gingival bleeding and gingival abrasion

T2 - A 4 week randomized controlled trial

AU - Mancinelli-Lyle, Deborah

AU - Van der Weijden, Fridus

AU - Slot, Dagmar E.

PY - 2025/2

Y1 - 2025/2

N2 - Aim: To determine the efficacy of a water flosser (WF) compared to an interdental brush (IDB) in reducing gingival inflammation. Additionally, the products were compared on the incidence of gingival abrasion.Methods: Young adults with moderate gingivitis and ≥4 accessible interdental spaces by IDB in each quadrant were selected for this study. Participants were randomly assigned a WF or an IDB as an adjunct to manual toothbrushing. Clinical signs of inflammation were measured in two randomly assigned contralateral quadrants by bleeding on pocket probing (BOPP) or bleeding on marginal probing (BOMP). Gingival Abrasion Score (GAS) was assessed per quadrant. Data was recorded at the baseline, 2 weeks and 4 weeks.Results: Both groups WF (n = 40) and IDB (n = 38) showed a significant reduction (p = 0.000) in BOMP and BOPP from the baseline to 4 weeks for all sites and the interdental sites only. At 4 weeks the WF group compared to the IDB group showed significantly lower BOPP (p = 0.030) and BOMP scores (p = 0.003) for all sites. For the interdental sites WF showed compared to IDB for BOMP significant (p = 0.019) lower values but not for BOPP (p = 0.219). There were no differences between the groups for GAS at any time point.Conclusion: In patients with moderate gingivitis, after 4 weeks use the WF is more effective than the IDB in obtaining marginal gingival health.

AB - Aim: To determine the efficacy of a water flosser (WF) compared to an interdental brush (IDB) in reducing gingival inflammation. Additionally, the products were compared on the incidence of gingival abrasion.Methods: Young adults with moderate gingivitis and ≥4 accessible interdental spaces by IDB in each quadrant were selected for this study. Participants were randomly assigned a WF or an IDB as an adjunct to manual toothbrushing. Clinical signs of inflammation were measured in two randomly assigned contralateral quadrants by bleeding on pocket probing (BOPP) or bleeding on marginal probing (BOMP). Gingival Abrasion Score (GAS) was assessed per quadrant. Data was recorded at the baseline, 2 weeks and 4 weeks.Results: Both groups WF (n = 40) and IDB (n = 38) showed a significant reduction (p = 0.000) in BOMP and BOPP from the baseline to 4 weeks for all sites and the interdental sites only. At 4 weeks the WF group compared to the IDB group showed significantly lower BOPP (p = 0.030) and BOMP scores (p = 0.003) for all sites. For the interdental sites WF showed compared to IDB for BOMP significant (p = 0.019) lower values but not for BOPP (p = 0.219). There were no differences between the groups for GAS at any time point.Conclusion: In patients with moderate gingivitis, after 4 weeks use the WF is more effective than the IDB in obtaining marginal gingival health.

KW - gingival abrasion

KW - gingival bleeding

KW - gingivitis

KW - interdental brush

KW - oral irrigator

KW - water flosser

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AN - SCOPUS:85198538544

SN - 1601-5029

VL - 23

SP - 176

EP - 185

JO - International Journal of Dental Hygiene

JF - International Journal of Dental Hygiene

IS - 1

ER -

Efficacy of a water flosser compared to an interdental brush on gingival bleeding and gingival abrasion: A 4 week randomized controlled trial

Abstract

Bibliographical note

Funding

Keywords

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