ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title No Significant Difference in a Comparison of Floss Picks to Traditional Floss for Interproximal Plaque Removal in Adults
Clinical Question In adults, are floss picks as effective as traditional floss, in terms of interproximal plaque removal?
Clinical Bottom Line There was no significant statistical difference between floss picks and traditional floss in removal of interproximal plaque.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17410948Blanck/200726 subjects (ages 19-64)Randomized Controlled Trial
Key resultsAlthough both products removed plaque efficiently, the “Mint Floss Pick removed 19.4%” where as “traditional floss removed 15%.” Therefore, the Mint Floss Picks removed 4.4% more plaque. Further statistical examination revealed a significant sequence effect. The order that the patient used the devices affected the results and led the researchers to conclude that the Floss Pick was "at least as good as" standard floss for plaque removal.
#2) 17022370Yost/2006120 subjects for 6 weeksRandomized Controlled Trial
Key results“In this study, dental floss, the recognized "gold standard" for gingivitis reduction, was matched in performance by flossers and an interdental cleaner with small elastomeric fingers, and surpassed by an interdental brush. All products performed comparably for plaque reduction and removal.” It was found that there are no statistical differences between the effectiveness of floss picks and traditional floss.
Evidence Search (interdental[All Fields] AND cleaning[All Fields]) AND Clinical Trial[ptyp] plaque-removal[All Fields] AND efficacy[All Fields] AND four[All Fields] AND types[All Fields] AND ("dental devices, home care"[MeSH Terms] OR ("dental"[All Fields] AND "devices"[All Fields] AND "home"[All Fields] AND "care"[All Fields]) OR "home care dental devices"[All Fields] OR ("dental"[All Fields] AND "floss"[All Fields]) OR "dental floss"[All Fields]) (Plaque-removal[All Fields] AND efficacy[All Fields] AND ("dental devices, home care"[MeSH Terms] OR ("dental"[All Fields] AND "devices"[All Fields] AND "home"[All Fields] AND "care"[All Fields]) OR "home care dental devices"[All Fields] OR ("dental"[All Fields] AND "floss"[All Fields]) OR "dental floss"[All Fields])) AND Clinical Trial[ptyp]
Comments on
The Evidence
Validity: Yost (2006) was a randomized, controlled study. 120 subjects who had interproximal spaces appropriate for the Gum Go-Betweens were assessed for plaque, gingivitis, and Eastman Interdental Bleeding Indices (EIBI) at baseline, given a prophylaxis, randomly assigned to one of four products. Blanck (2007) was a single blind, crossover clinical trial, randomized controlled trial on patients ages 19-64, individuals were evaluated according to the Modified Turskey Plaque Index, in which they had to meet a minimum criteria of 1.5 to participate in the study. There were no significant P values were reported in either study. In both studies, Blanck and Yost the study groups were not clearly defined in regard to number of individuals per age group or health status. Perspective: When comparing floss to floss picks, it is logical that floss picks may be more effective in plaque removal based upon the age of the patient as well as patient compliance. When finding the most effective method to remove plaque it is necessary to take into account the patient's age and/or dexterity level. Often, these two go hand in hand. If a patient is older, it will be more difficult for he or she to manipulate traditional floss, therefore making floss picks the more effective method. Even though floss picks don’t have the anatomical c-shape to them, the fact that they are easier to use increases patient compliance, which in turn may increase the amount of plaque removed.
Applicability Floss picks are a more practical choice for patients who have limited dexterity. Floss picks cause less discomfort than traditional floss in patients who have limited mobility. Finding an interdental product that is simple as well as effective is a motivational factor for many patients for a proper at home oral hygiene regimen.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Floss, floss picks, plaque, interproximal care, traditional floss
ID# 2766
Date of submission: 09/02/2014spacer
E-mail nicholsonl@livemail.uthscsa.edu
Author Lindsey Nicholson
Co-author(s) Emily Holland
Co-author(s) e-mail HollandEL@livemail.uthscsa.edu
Faculty mentor/Co-author Carol A. Nguyen, MPH, MS
Faculty mentor/Co-author e-mail NGUYENC@uthscsa.edu
Basic Science Rationale
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