Effectiveness of Super Floss and Water Flosser in Plaque Removal for Patients Undergoing Orthodontic Treatment: A Randomized Controlled Trial

Nozha Sawan; Afnan Ben Gassem; Faisal Alkhayyal; Aroob Albakri; Nada Al-Muhareb; Eman Alsagob

doi:10.1155/2022/1344258

Effectiveness of Super Floss and Water Flosser in Plaque Removal for Patients Undergoing Orthodontic Treatment: A Randomized Controlled Trial

Int J Dent. 2022 Aug 31:2022:1344258. doi: 10.1155/2022/1344258. eCollection 2022.

Authors

Nozha Sawan¹, Afnan Ben Gassem², Faisal Alkhayyal³, Aroob Albakri⁴, Nada Al-Muhareb⁴, Eman Alsagob¹

Affiliations

¹ Preventive Dental Sciences Department, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
² Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia.
³ Director of the Quality & Patient's Safety Department at Riyadh Specialized Dental Center, Riyadh, Saudi Arabia.
⁴ College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

Abstract

Objectives: This study aimed to compare the effectiveness of super floss and water flosser in plaque removal for patients undergoing orthodontic treatment.

Methods: A single-blind, randomized, controlled, parallel clinical trial with a split-mouth protocol was conducted on young adult orthodontic patients who were recruited from Riyadh Specialized Dental Center in Riyadh, Saudi Arabia. The type of floss used was randomly assigned to each side of the oral cavity; Super-Floss® (Oral-B) was used on one side, while the Waterpik® water flosser was used on the other. Patients' plaque level was assessed using Rustogi et al. modified navy plaque index (RMNPI) at baseline and immediately after cleaning.

Results: A total of 62 subjects were screened; however, only 34 subjects were enrolled in the study with an equal number of males and females. Overall, the plaque score was significantly reduced from 0.56 ± 0.35 to 0.13 ± 0.26 in the super floss group and from 0.61 ± 0.35 to 0.13 ± 0.28 in the water flosser group. There was no significant difference between the mean difference of super floss and water flosser (p=0.951). On the other hand, there was no significant difference between both groups in terms of the preintervention plaque score (p=0.379). The water flosser had a greater effect size on plaque removal compared to super floss on distal interproximal surface of the molar tooth with a mean difference of (-0.21, 95% CI: 00.37 to -0.04, p=0.033).

Conclusions: The use of super floss or water flosser as interproximal aids for plaque removal in patients undergoing orthodontic treatment are both effective. Trial registration. ISRCTN, ISRCTN83875016. Registered 12 September 2021-retrospectively registered, https://www.isrctn.com/ISRCTN83875016.