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Title Oral Irrigation Is Effective When Used In Addition To Tooth Brushing As An Alternative To Flossing
Clinical Question Can Patients use a waterpik (oral irrigation) instead of floss?
Clinical Bottom Line Oral irrigation is as effective as flossing when used in conjunction with tooth brushing. (See Comments on the CAT below)
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) 16305005Barnes/200595 subjectsRandomized Controlled Trial
Key resultsBleeding Index: Irrigation groups statistically significantly more effective than flossing. Gingival Index: Significant difference between irrigation and flossing on both the facial and lingual surfaces. Plaque Index: The manual toothbrush and floss were less effective than the sonic toothbrush and irrigation. There was no statistical difference between the groups that both used manual toothbrushes but differed in floss use versus irrigation.
Evidence Search Dental Devices, Home Care[Mesh] AND (floss[All Fields] AND alternative[All Fields]) AND Randomized Controlled Trial[ptyp]
Comments on
The Evidence
There should have been a sonic toothbrush and floss group to compare to as well. Although the irrigation group did as well as the flossing group, there does not seem to be an advantage to irrigation. There may be an advantage to the sonic toothbrush.
Applicability Any patient in braces or with manual dexterity problems or any patient that just will not floss.
Specialty/Discipline (Public Health) (General Dentistry) (Orthodontics) (Pediatric Dentistry) (Periodontics) (Restorative Dentistry) (Dental Hygiene)
Keywords floss, waterpik, oral irrigation, dental water jet, difficulty flossing
ID# 480
Date of submission: 01/06/2010spacer
E-mail cooperrb@uthscsa.edu
Author R. Bryn Cooper
Co-author(s) e-mail
Faculty mentor/Co-author Adriana V. Green, DDS, MPH
Faculty mentor/Co-author e-mail vargasa0@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
post a comment
by Alejandro J. Trevino (San Antonio, Tx) on 04/10/2012
I conducted a PubMed search on this topic during early April 2012. The evidence posted on this CAT are the most recent pertaining to comparison of typical floss and a waterpik. There are more recent publications, but compare to other devices like sonicare air floss with a waterpik.

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