Interdental Cleaning and Oral Health Status in an Adult Cohort, 2015 to 2018

Abstract

Interdental cleaning is routinely recommended, despite limited evidence supporting efficacy to prevent advanced oral disease endpoints, such as caries and periodontal disease. We aimed to examine associations between interdental cleaning and oral health in a large, generalizable prospective cohort of adults in the United States. Data were drawn from wave 3 (2015 to 2016, n = 26,086 included in analysis) and wave 4 (2016 to 2018, n = 22,585) of the adult component (age ≥18 y) of the nationally representative Population Assessment of Tobacco and Health Study. Survey-weighted multivariable regression models estimated the associations between wave 3 weekly interdental cleaning frequency and 6 measures of self-reported oral health—overall rating, tooth extractions, gum bleeding, loose teeth, bone loss around teeth, and gum disease—cross-sectionally and prospectively, with adjustment for established periodontal disease risk factors. As compared with no interdental cleaning, interdental cleaning ≥7 times/wk was prospectively associated with greater odds of excellent self-rated oral health (adjusted odds ratio, 1.37; 95% CI, 1.17 to 1.62), lower odds of bleeding gums (adjusted odds ratio, 0.62; 95% CI, 0.54 to 0.70), but not statistically significantly lower odds of other oral health conditions in the following 12 mo. Older age, lower socioeconomic status, diabetes, and cigarette smoking were consistently associated with worse oral health across all outcome measures. Findings were largely robust to alternative model and variable specifications. Interdental cleaning is associated with better perceived oral health and less self-reported gingivitis. Prevention of more advanced disease states was not demonstrated. These findings should be interpreted cautiously given the self-reported nature of the measures and relatively short follow-up period.

The use of interdental cleaning devices and periodontal disease contingent on the number of remaining teeth in Korean adults

“…A recently published nationally representative longitudinal study revealed that frequent interdental cleaning is associated with better self-perceived oral health and less volume of gingival bleeding but less with measures of more advanced periodontal disease 10 . The proportion of participants who used interdental cleaners in NHANES from United States exceeded 70%.…”

“…Based on a recent large-scale longitudinal study, interdental cleaning could alleviate self-reported gingivitis. However, its effectiveness in preventing advanced periodontitis has not been confirmed 10 . According to the study of Kim and Han, dental floss, but not interdental brushes, could prevent periodontal disease 8 .…”

The Use of Interdental Care Products in Korean Adults Aged 30 Years and Older and Factors Affecting Their Use: 4th to 7th Korean National Health and Nutrition Examination Survey

“…According to the Cochrane Review [ 8 ], DF or ICP in addition to toothbrushing may reduce gingivitis, biofilm formation, or both more efficiently than toothbrushing alone. In a cohort study conducted in the United States [ 30 ], interdental cleaning was associated with a reduction in self-reported gingivitis, and several epidemiological studies [ 14 , 29 ] have also reported that interdental cleaning and the use of DF and IDB among various ICPs could reduce gingivitis and biofilm. In this study, it was also confirmed that when interdental cleaning was performed using one or more DF or IDB, the gingivitis OR decreased to 0.721 (95% CI: 0.676–0.770) and periodontitis OR decreased to 0.642 (95% CI: 0.597–0.690).…”

Tobacco Use and Incidence of Adverse Oral Health Outcomes Among US Adults in the Population Assessment of Tobacco and Health Study

“…9 The majority of epidemiological evidence supporting a positive association between ENDS use and adverse oral health comes from cross-sectional studies [10][11][12][13][14] ; longitudinal findings have been inconsistent. 15,16 Understanding health effects of tobacco use, particularly of noncigarette products, is one of the US Food and Drug Administration's (FDA) tobacco regulatory research priorities. 17 We examined associations between tobacco use and the incidence of adverse oral health outcomes (ie, gum bleeding, precancerous oral lesions, bone loss around teeth, bleeding after brushing or flossing, loose teeth, and 1 or more teeth removed) across different tobacco products among adults (aged Ն18 years) using data from the Population Assessment of Tobacco and Health (PATH) Study, a unique resource for longitudinal measures on tobacco use and oral health in a US nationally representative sample.…”