The Efficacy and Safety of Oral Irrigator on the Control of Dental Plaque and Gingivitis: A Randomized, Single-Blind, Parallel-Group Clinical Trial

Abstract

Background: To evaluate the efficacy and safety of oral irrigator (OI) in controlling dental plaque and gingivitis. Methods: Ninety participants diagnosed with gingivitis were randomly assigned to two groups, given a toothbrush combined with OI (WaterPik®) (test) or a toothbrush alone (control). The Turesky-Modified Quigley-Hein Plaque Index (T-QH), Modified Gingival Index (MGI), Bleeding Index (BI), and percentage of sites with bleeding on probing (BOP%) were evaluated at baseline, 4 weeks, 8 weeks, and 12 weeks. The full analysis set (FAS) and per-protocol set (PPS) were analyzed. Adverse events were recorded through electronic diaries and examinations. Results: Of the 90 participants, the efficacy was assessed in the following numbers (FAS/PPS): test (45/33) and control (43/38). Compared with the control, MGI, BI, and BOP% were significantly lower in the test group after 4 weeks (4 weeks: p = 0.017, p = 0.001, and p = 0.001, respectively; 8 weeks and 12 weeks: p < 0.001 for all, FAS); T-QH was significantly lower after 8 weeks (8 weeks: p = 0.033; 12 weeks: p = 0.006, FAS). Transient gingival bleeding may be associated with OI. Self-reported pain and dentin hypersensitivity symptoms were similar between groups. Conclusions: As adjuncts to toothbrushing, OI demonstrated significantly better efficacy in controlling dental plaque and gingival inflammation with no substantial safety hazards.

Efficacy of water flossing on clinical parameters of inflammation and plaque: A 4‐week randomized controlled trial

“…The differences between the WF and DF in this study were in line with other studies conducted since 2004, demonstrating that WF is superior for reducing plaque, gingival bleeding and gingival inflammation scores 12–17 . Studies using water enriched with microbubbles of oxygen are limited.…”

“…The protocol followed the ADA guidelines for interdental cleaners for measuring plaque and gingivitis reductions 38,39 . The methodology, inclusion criteria and intervention are similar to several other published clinical trials 13–19 . This is important to evaluate reproducibility and provide a base of RCT for systematic reviews and meta‐analysis.…”

“…Studies on a pulsating water flosser show a statistically significant reduction in BOP and MGI over 4 weeks 12,14,15,17–19,53–56 . Comparisons to dental floss, 12–16 interdental brush, 54–56 and air flosser 18,19 have been reported with the pulsating water flosser demonstrating superior benefits for individuals with gingivitis.…”

“…Since then, more recent studies have compared the efficacy of water flossers to other interdental cleaning devices, such as dental floss, interdental brushes and air floss 12–19 . These studies have shown that water flossers are more effective than traditional flossing in removing plaque and reducing gingival inflammation 12–16 .…”

“…[9][10][11] Since then, more recent studies have compared the efficacy of water flossers to other interdental cleaning devices, such as dental floss, interdental brushes and air floss. [12][13][14][15][16][17][18][19] These studies have shown that water flossers are more effective than traditional flossing in removing plaque and reducing gingival inflammation. [12][13][14][15][16] Additionally, water flossers are more comfortable and easier to use than conventional floss, especially for individuals with orthodontic appliances or dental restorations.…”