Key messages:
- Water flossers may be more effective in plaque removal than dental floss, especially from inaccessible interproximal areas.
- Clients with dental prostheses, undergoing orthodontic treatment, or with limited manual dexterity may find water flossers helpful.
- Deterrents to water flosser use may include cost, storage space, and the need for water and energy, which can impact its use outside the home.
Introduction
Dental plaque biofilm consists of various bacteria that adhere firmly to tooth surfaces. Certain bacterial species within the oral biofilm are associated with dental caries and periodontal disease development. Therefore, daily dental plaque removal is essential to maintain good oral health.
Toothbrushing can remove supragingival plaque from the facial and lingual surfaces of teeth. However, toothbrushing cannot effectively reach interdental areas, where most periodontal issues start. Therefore, plaque removal from these areas is of utmost importance. Interdental aids, such as dental floss and water flossers, are effective in removing interdental plaque.
Objective
This systematic review compared the available data on the efficacy of dental floss and water flossers in removing plaque in adults.
Methods
PubMed, Scopus, Cochrane, ScienceDirect, Lilac, and Google Scholar were searched for relevant articles from January 1, 2002, to October 31, 2022. Two reviewers independently screened study titles.
Seven articles met the eligibility criteria. These studies were randomized controlled trials comparing dental floss and water flossers, with plaque score reduction as the primary assessed outcome.
Findings
Most of the studies favoured water flossers over dental floss in plaque reduction. Water flossers were also found to be more effective than dental floss in removing plaque from inaccessible interproximal areas of the tooth surfaces.
Conclusions
The available evidence suggests water flossers can be an effective alternative to dental floss in individuals with limited manual dexterity, clients undergoing orthodontic treatment, and those with dental prostheses.
Further studies need to be conducted with appropriate sample sizes, study design, methodology, and follow-up periods to improve the quality of the research. These studies should also assess client compliance with using water flossers and dental floss.
