ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Interdental Brushes Are As Effective As Floss In Removing Interproximal Plaque
Clinical Question In patients 18 years and older, are interdental brushes as effective as traditional waxed floss in reducing interproximal plaque?
Clinical Bottom Line In patients 18 years and older, interdental brushes are as effective as traditional floss in reducing interproximal plaque. This is supported by a meta analysis of multiple studies and a randomized controlled trial in which interdental brushes performed equally well, and in some studies better, as compared to floss by a clinically significant margin. Use of an interdental brush is easier to use and less technique sensitive for most patients and will likely result in increased use in comparison to floss.
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) 19138177Slot/2008510 adult patients from 9 included studiesMeta-Analysis
Key results“A significant effect was seen when comparing the interdental brush with the floss group when using the Silness and Loë plaque index [WMD: −0.48, 95% CI (−0.65, −0.32), P < 0.00001; test for heterogeneity P = 0.001, I2 = 85.4%].”
#2) 16881811Jackson/200677 patients with chronic periodontitisRandomized Controlled Trial
Key resultsThe baseline mean plaque index (PI) for the brush group (1.12) was equivalent to the floss group (1.13). “The 6-week mean PI for the brush group (0.68) was significantly less than for the floss group (1.00) (P <0.001)...There was still significantly less interdental plaque in the brush group (.72) than for the floss group (.96) at 12 weeks (P <0.01).”
Evidence Search ("Dental Devices, Home Care") AND ("Dental Plaque/prevention and control")
Comments on
The Evidence
Validity: The first article is a systematic review including a meta analysis of randomized controlled clinical trials or controlled clinical trials. After searching the National Library of Medicine and the Cochrane central register, 234 articles were screened. Of those, only 9 were chosen based upon the studies’ validity and the requirements of review. The second article is a randomized controlled clinical trial in which 77 out of 87 patients completed the trial. The groups were randomly chosen and clinically similar at the start of the study. The trial was a single blind study in which the two groups were treated the same, had adequate followup, adequate compliance, and unlikely recall bias.
Applicability This would be applicable for most patients, and especially patients that have periodontal disease. It is also very applicable to patients who have musculoskeletal problems and would have difficulty flossing.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Interdental brush, floss, plaque index
ID# 3041
Date of submission: 03/31/2016spacer
E-mail craigj3@livemail.uthscsa.edu
Author James Craig
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Archie Jones, DDS
Faculty mentor/Co-author e-mail JonesA@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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