The effect of different interdental cleaning devices on gingival bleeding

Objective: To compare the effectiveness of an oral irrigator (OI) with a prototype jet
tip or a standard jet tip to floss as adjunct to daily toothbrushing on gingival bleeding.
Methods: In this single masked, 3-group parallel, 4-week home use experiment, 108
subjects were randomly assigned to one of three groups: 1) OI with a prototype jet tip;
2) OI with a standard jet tip; 3) waxed dental floss. All groups used their assigned product
once a day as adjunct to twice daily toothbrushing for two minutes with a standard
ADA reference toothbrush. Professional instructions were given by a dental hygienist in
OI use or floss use according to written instructions. All subjects also received a toothbrush
instruction leaflet (Bass technique). Subjects were assessed for both bleeding and
plaque at baseline and after two weeks and four weeks and were instructed to brush
their teeth approximately 2 to 3 hours prior to their assessment. Results: With respect to
mean bleeding scores the ANCOVA analysis with baseline as covariate and week 4 as
dependent variable showed a significant difference between groups in favor of both the
oral irrigator groups. For plaque, however, no significant difference among groups was
observed. Conclusion: When combined with manual toothbrushing the daily use of an
oral irrigator, either with prototype or standard jet tip, is significantly more effective in
reducing gingival bleeding scores than is the use of dental floss, as determined within
the limits of this 4-week study design.