Efficacy of water flossing on clinical parameters of inflammation and plaque: A 4-week randomized controlled trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 37753575 · doi:10.1111/idh.12770
What was done
In a 4-week, single-centre, single-blind parallel randomized controlled trial, 105 participants were assigned to one of three groups used alongside a manual toothbrush: standard pulsating water flosser (WF), air microbubble-infused pulsating water flosser (MBWF), or conventional dental floss (DF). Bleeding on probing (BOP), Modified Gingival Index (MGI), and Rustogi Modification Navy Plaque Index (RMNPI) scores were measured at baseline, 2 weeks, and 4 weeks.
What was found
All 105 participants completed the study. At 4 weeks, all groups demonstrated statistically significant reductions in BOP, MGI, and RMNPI (p < 0.05, except marginal RMNPI for the DF group). The WF group achieved significantly greater whole-mouth reductions than MBWF and DF for BOP (0.41 vs. 0.32 vs. 0.19), MGI (0.37 vs. 0.30 vs. 0.20), and RMNPI (0.13 vs. 0.11 vs. 0.06; p < 0.05 for all pairwise comparisons). No adverse events occurred.
Why it matters
This study provides direct comparative evidence that adding a water flosser to manual toothbrushing reduces short-term plaque and gingivitis markers more effectively than manual brushing with dental floss, with standard pulsating water outperforming microbubble-infused water.
Limits
The trial had a short follow-up duration (4 weeks) and was conducted at a single centre. Participants could not be blinded to the intervention type, and baseline patient characteristics, compliance, and long-term clinical periodontal outcomes were not reported in the abstract.
Cited by
- supports Studies demonstrate that pulsating water flossers (such as Waterpik), when used correctly, are more effective than traditional dental floss at cleaning periodontal pockets.