Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?

Abstract

Objective To assess whether bacterial colonisation in a power-driven water flosser can be prevented. Materials and methods Twenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp. Results Contamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19–56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans. Conclusion Neither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU. Clinical relevance Bacterial colonisation in a power-driven water flosser seems impossible to prevent; to restrict the risk of cross-contamination within a household, one device per person should be recommended.

Efficacy of power‐driven interdental cleaning tools: A systematic review and meta‐analysis

“…In general, all studies included herein reported that PDICTs are indeed safe to use. Nevertheless, recent reports from our group have indicated that liquid‐based PDICTs are unavoidably colonized by oral bacteria, which can be transmitted via the water jet (Bertl, Edlund Johansson, Bruckmann et al, 2021 ; Bertl et al, 2022 ). Contamination of a specific liquid‐based PDICT with Streptococcus mutans was found in >95% of the samples, while periodontal pathogens were detected in 19%–56% of the samples (Bertl et al, 2022 ).…”

“…Nevertheless, recent reports from our group have indicated that liquid‐based PDICTs are unavoidably colonized by oral bacteria, which can be transmitted via the water jet (Bertl, Edlund Johansson, Bruckmann et al, 2021 ; Bertl et al, 2022 ). Contamination of a specific liquid‐based PDICT with Streptococcus mutans was found in >95% of the samples, while periodontal pathogens were detected in 19%–56% of the samples (Bertl et al, 2022 ). Based on these reports, the commonly suggested use of the same device within families, with only exchanging the device tip among family members, should be reconsidered.…”

A Comparative Review of Water Flossers in Periodontal Therapy

“…Furthermore, concerns about bacterial colonization and the risk of cross-contamination have been raised during regular daily use of power-driven WFs [ 53 ]. Dental irrigators can cause transient bacteremia, with incidence correlated to oral hygiene and periodontal disease [ 54 ].…”

“…A major issue, as highlighted in our literature review, lies in the limited comparative evidence, and lack of systematic reviews regarding the efficacy of WFs in the management of periodontal disease. There have been studies, which show that there is little to no effect on the composition of subgingival plaque and reducing periodontal pockets [51,52] Furthermore, concerns about bacterial colonization and the risk of cross-contamination have been raised during regular daily use of power-driven WFs [53]. Dental irrigators can cause transient bacteremia, with incidence correlated to oral hygiene and periodontal disease [54].…”

Diş hekimliğinde esansiyel yağların kullanımı

“…ntimikrobiyal, antiinflamatuvar, antiseptik, antifungal ve antikaryojenik özelliklerinden dolayı diş hekimliğinde diş macunu, jel ve gargara formülasyonlarda yer alan esansiyel yağların diş ve diş eti hastalıklarında önemli terapötik etkinliğe sahip olduğunu gösteren çalışmalar literatürde yer almaktadır. Günümüzde esansiyel yağların periodontal hastalıklar üzerindeki teröpatik etklerinin daha iyi anlaşılması ve esansiyel yağ bazlı yeni formülasyonların geliştirilmesi adına in vitro,in vivo çalışmalar ve hayvan deneyleri yapılmaya devam edilmektedir (44)(45)(46)(47)(48)(49)(50). Tüm bu bilgiler ışığında esansiyel yağların periodontal hastalıkların tedavisinde kullanımı araştırmaya hala açık olan bir konudur.…”