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| Title |
Using a Water Flosser Can Be Effective in Managing Plaque During Orthodontic Treatment When Used in Conjunction With Other Oral Hygiene Modalities |
| Clinical Question |
For patients who are having a hard time cleaning their teeth effectively during orthodontic treatment, is a Waterpik flosser as effective as regular floss with regards to plaque control? |
| Clinical Bottom Line |
For patients struggling with effective oral hygiene during orthodontic treatment with fixed appliances, there is some evidence that shows that using a Waterpik can help to reduce plaque accumulation but not all evidence shows that this treatment is better than traditional flossing or using a manual toothbrush exclusively. A RCT with 34 subjects showed that there was no significant difference between using Super Floss and using a water flosser. This RCT did show that both methods significantly reduced the overall plaque score. A different clinical trial showed that a water flosser was more effective than traditional 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) 36090126 | Sawan/2022 | 34 subjects with an equal number of males and females | Randomized Controlled Trial | | Key results | There was no significant difference between using Super Floss or a water flosser for patients undergoing orthodontic treatment, but there was significant overall reduction in the plaque score for both methods. This study was conducted using split mouth protocol on young adult orthodontic patients with a mean age of 23.7 +/- 7.7 yrs. | | #2) 15711898 | Kossack/2005 | 40 patients split into four groups randomly | Single blind 4 way crossover clinical trial | | Key results | The Sonic Speed brush in combination with a Waterpik was the only method used that was found to be significantly better than a manual toothbrush after 4 weeks of application. This improvement was mainly attributed to the Waterpik and was more effective than dental floss. It is important to note that “in patients with good oral hygiene, no improvement was observed with any of the cleaning aids.” | | #3) 37203873 | Tyler/2023 | 40 patients between 10-20 yo in fixed appliances | Randomized Controlled Trial | | Key results | There was no significant difference in the plaque index, gingival index or interdental bleeding index when comparing results from patients using only a manual toothbrush and patients using a Waterpik in addition to a manual toothbrush. | |
| Evidence Search |
Waterpik + orthodontic treatment AND
Waterpik + plaque control |
Comments on
The Evidence |
These studies were randomized clinical trials and provide a high level of evidence. There were control groups for two of the studies and the third was a crossover clinical trial so both experimental treatments were completed on the same patient, just on different sides of the mouth. |
| Applicability |
The patients in the included studies were mostly young adults so it would be difficult to apply these findings to children or younger patients undergoing orthodontic treatment. It also does not address the challenges some patients face using floss and threading it between the brackets. Dexterity and the time necessary to floss are not factors that were considered. |
| Specialty/Discipline |
(Orthodontics) |
| Keywords |
Waterpik, orthodontic treatment, fixed appliances, oral hygiene, plaque
|
| ID# |
3538 |
| Date of submission: |
10/17/2023 |
| E-mail |
meyern1@livemail.uthscsa.edu |
| Author |
Nicole Meyer |
| Co-author(s) |
Jeremy Haqq |
| Co-author(s) e-mail |
abdulhaqq@livemail.uthscsa.edu |
| Faculty mentor/Co-author |
Maria Karakousoglou |
| Faculty mentor/Co-author e-mail |
Karakousoglo@livemail.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?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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