{"title":"三种控制牙间菌斑的辅助工具(牙线、水牙线和牙间刷)作为儿童刷牙的辅助工具的效果。","authors":"Annam George, Jayanthi Mungara, Poornima Vijayakumar, Deebiga Karunakaran, Shanthosh Raj, Abirami Kumar","doi":"10.5005/jp-journals-10005-3140","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>General well-being of an individual, particularly oral health, depends on the maintenance of optimal oral hygiene. Evidence-based research has established the role of plaque biofilm as an etiologic factor that increases the risk of developing oral diseases such as dental caries and gingival and periodontal diseases. Brushing with either manual or mechanical toothbrushes is most commonly practiced for the removal of plaque, but its efficiency is limited to surfaces it can access, i.e., facial, lingual, and occlusal surfaces of the teeth. During the mixed dentition period, there is closure of all physiological spaces and establishment of tight proximal contact, increasing the risk of proximal caries and gingival diseases if appropriate plaque control measures are not undertaken.Numerous interdental cleaning aids are available in the market, such as dental floss, interdental brushes, wooden interdental aids, and oral irrigators, to support patients' self-care needs. Dental floss is used along with toothbrushing for interdental plaque removal in both primary and permanent dentition. It may act differently on the primary tooth due to its distinct anatomy-bulbous crowns, broad, flat contact areas, and cervical constrictions. Floss types include waxed, unwaxed, bonded, unbonded, and those with drug additives, with handles such as stick floss of F-type and Y-type.Interdental brushes are found to be effective in removing interdental plaque, as recommended by the European Federation of Periodontology 2015 workshop. They can reach interdental grooves or fissures that are not physically accessible to other devices, are safe and easy to use, and their selection depends on individual needs. Oral irrigators, such as the dental water jet-first introduced in 1962 by a Colorado dentist and now known as the water flosser-have the advantage of reaching inaccessible areas in both open and closed dentitions. They are effective in plaque removal, can be used with chemical plaque control agents, and are considered to be three times more effective than manual brushing. Water flossers are also useful for children with special healthcare needs.However, complete removal of plaque biofilm remains a challenge and depends on a child's manual dexterity, devices used, skills acquired through training, appropriate technique, and frequency of oral hygiene practice. With this background, the present study was undertaken to assess and compare the plaque removal efficiency of three interdental cleaning devices as an adjunct to brushing in children with mixed dentition.</p><p><strong>Materials and methods: </strong>The present study was conducted by the Department of Pedodontics and Preventive Dentistry. A total of 308 children were screened, and 100 children aged 6-12 years with a minimum of 20 scorable teeth, free of systemic diseases and willing to participate with informed consent, were selected. Children with oral lesions, dental caries, or developmental disturbances of the teeth or systemic diseases affecting oral hygiene practices were excluded.At the initial visit, oral hygiene status was assessed and scored using the Rustogi Modified Navy Plaque Index (RMNPI) following standard protocols. Two-tone plaque disclosing solution was applied to all tooth surfaces using a cotton swab and left for 1 minute. Petroleum jelly was applied to the oral mucosa to prevent staining. After rinsing with water spray and suction for 30 seconds, plaque staining was evaluated. Each of the nine areas on buccal and lingual surfaces (including marginal and approximal regions) was scored, and the mean was calculated. Intraoral photographs were taken to reconfirm scores.Children were randomly divided into four groups of 25 each and trained in brushing and the use of interdental aids:Group I: Interdental floss (STIM flexible)Group II: Water flosser (Oracura-Prima)Group III: Interdental brush (STIM-Proxa angular brush)Group IV: Toothbrushing alone (Colgate Junior toothbrush)All groups practiced their assigned method for 4 weeks. Oral hygiene status was reassessed after 4 weeks using the same methodology. Data were tabulated in Microsoft Excel and analyzed using SPSS v22.0. Paired <i>t</i>-test was used for within-group comparison, analysis of variance (ANOVA) for between-group comparison, and Bonferroni test for multiple comparisons. A <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The results showed a significant reduction in plaque scores from baseline following toothbrushing (<i>p</i> = 0.000). No significant difference in plaque removal efficiency was observed between toothbrushing and flossing (<i>p</i> > 0.05), nor between floss, interdental brush, and oral irrigator (<i>p</i> > 0.05). However, oral irrigators and interdental brushes were significantly more effective than toothbrushing alone (<i>p</i> = 0.0087 and <i>p</i> = 0.0027, respectively).</p><p><strong>Conclusion: </strong>Adjunctive aids such as dental floss, interdental brushes, and oral irrigators are recommended along with toothbrushing for better plaque control and prevention of caries and gingival diseases in children.</p><p><strong>How to cite this article: </strong>George A, Mungara J, Vijayakumar P, <i>et al.</i> Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children. Int J Clin Pediatr Dent 2025;18(6):637-640.</p>","PeriodicalId":36045,"journal":{"name":"International Journal of Clinical Pediatric Dentistry","volume":"18 6","pages":"637-640"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486515/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children.\",\"authors\":\"Annam George, Jayanthi Mungara, Poornima Vijayakumar, Deebiga Karunakaran, Shanthosh Raj, Abirami Kumar\",\"doi\":\"10.5005/jp-journals-10005-3140\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>General well-being of an individual, particularly oral health, depends on the maintenance of optimal oral hygiene. Evidence-based research has established the role of plaque biofilm as an etiologic factor that increases the risk of developing oral diseases such as dental caries and gingival and periodontal diseases. Brushing with either manual or mechanical toothbrushes is most commonly practiced for the removal of plaque, but its efficiency is limited to surfaces it can access, i.e., facial, lingual, and occlusal surfaces of the teeth. During the mixed dentition period, there is closure of all physiological spaces and establishment of tight proximal contact, increasing the risk of proximal caries and gingival diseases if appropriate plaque control measures are not undertaken.Numerous interdental cleaning aids are available in the market, such as dental floss, interdental brushes, wooden interdental aids, and oral irrigators, to support patients' self-care needs. Dental floss is used along with toothbrushing for interdental plaque removal in both primary and permanent dentition. It may act differently on the primary tooth due to its distinct anatomy-bulbous crowns, broad, flat contact areas, and cervical constrictions. Floss types include waxed, unwaxed, bonded, unbonded, and those with drug additives, with handles such as stick floss of F-type and Y-type.Interdental brushes are found to be effective in removing interdental plaque, as recommended by the European Federation of Periodontology 2015 workshop. They can reach interdental grooves or fissures that are not physically accessible to other devices, are safe and easy to use, and their selection depends on individual needs. Oral irrigators, such as the dental water jet-first introduced in 1962 by a Colorado dentist and now known as the water flosser-have the advantage of reaching inaccessible areas in both open and closed dentitions. They are effective in plaque removal, can be used with chemical plaque control agents, and are considered to be three times more effective than manual brushing. Water flossers are also useful for children with special healthcare needs.However, complete removal of plaque biofilm remains a challenge and depends on a child's manual dexterity, devices used, skills acquired through training, appropriate technique, and frequency of oral hygiene practice. With this background, the present study was undertaken to assess and compare the plaque removal efficiency of three interdental cleaning devices as an adjunct to brushing in children with mixed dentition.</p><p><strong>Materials and methods: </strong>The present study was conducted by the Department of Pedodontics and Preventive Dentistry. A total of 308 children were screened, and 100 children aged 6-12 years with a minimum of 20 scorable teeth, free of systemic diseases and willing to participate with informed consent, were selected. Children with oral lesions, dental caries, or developmental disturbances of the teeth or systemic diseases affecting oral hygiene practices were excluded.At the initial visit, oral hygiene status was assessed and scored using the Rustogi Modified Navy Plaque Index (RMNPI) following standard protocols. Two-tone plaque disclosing solution was applied to all tooth surfaces using a cotton swab and left for 1 minute. Petroleum jelly was applied to the oral mucosa to prevent staining. After rinsing with water spray and suction for 30 seconds, plaque staining was evaluated. Each of the nine areas on buccal and lingual surfaces (including marginal and approximal regions) was scored, and the mean was calculated. Intraoral photographs were taken to reconfirm scores.Children were randomly divided into four groups of 25 each and trained in brushing and the use of interdental aids:Group I: Interdental floss (STIM flexible)Group II: Water flosser (Oracura-Prima)Group III: Interdental brush (STIM-Proxa angular brush)Group IV: Toothbrushing alone (Colgate Junior toothbrush)All groups practiced their assigned method for 4 weeks. Oral hygiene status was reassessed after 4 weeks using the same methodology. Data were tabulated in Microsoft Excel and analyzed using SPSS v22.0. Paired <i>t</i>-test was used for within-group comparison, analysis of variance (ANOVA) for between-group comparison, and Bonferroni test for multiple comparisons. A <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The results showed a significant reduction in plaque scores from baseline following toothbrushing (<i>p</i> = 0.000). No significant difference in plaque removal efficiency was observed between toothbrushing and flossing (<i>p</i> > 0.05), nor between floss, interdental brush, and oral irrigator (<i>p</i> > 0.05). However, oral irrigators and interdental brushes were significantly more effective than toothbrushing alone (<i>p</i> = 0.0087 and <i>p</i> = 0.0027, respectively).</p><p><strong>Conclusion: </strong>Adjunctive aids such as dental floss, interdental brushes, and oral irrigators are recommended along with toothbrushing for better plaque control and prevention of caries and gingival diseases in children.</p><p><strong>How to cite this article: </strong>George A, Mungara J, Vijayakumar P, <i>et al.</i> Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children. Int J Clin Pediatr Dent 2025;18(6):637-640.</p>\",\"PeriodicalId\":36045,\"journal\":{\"name\":\"International Journal of Clinical Pediatric Dentistry\",\"volume\":\"18 6\",\"pages\":\"637-640\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486515/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Pediatric Dentistry\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/jp-journals-10005-3140\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"Dentistry\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Pediatric Dentistry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10005-3140","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Dentistry","Score":null,"Total":0}
Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children.
Introduction: General well-being of an individual, particularly oral health, depends on the maintenance of optimal oral hygiene. Evidence-based research has established the role of plaque biofilm as an etiologic factor that increases the risk of developing oral diseases such as dental caries and gingival and periodontal diseases. Brushing with either manual or mechanical toothbrushes is most commonly practiced for the removal of plaque, but its efficiency is limited to surfaces it can access, i.e., facial, lingual, and occlusal surfaces of the teeth. During the mixed dentition period, there is closure of all physiological spaces and establishment of tight proximal contact, increasing the risk of proximal caries and gingival diseases if appropriate plaque control measures are not undertaken.Numerous interdental cleaning aids are available in the market, such as dental floss, interdental brushes, wooden interdental aids, and oral irrigators, to support patients' self-care needs. Dental floss is used along with toothbrushing for interdental plaque removal in both primary and permanent dentition. It may act differently on the primary tooth due to its distinct anatomy-bulbous crowns, broad, flat contact areas, and cervical constrictions. Floss types include waxed, unwaxed, bonded, unbonded, and those with drug additives, with handles such as stick floss of F-type and Y-type.Interdental brushes are found to be effective in removing interdental plaque, as recommended by the European Federation of Periodontology 2015 workshop. They can reach interdental grooves or fissures that are not physically accessible to other devices, are safe and easy to use, and their selection depends on individual needs. Oral irrigators, such as the dental water jet-first introduced in 1962 by a Colorado dentist and now known as the water flosser-have the advantage of reaching inaccessible areas in both open and closed dentitions. They are effective in plaque removal, can be used with chemical plaque control agents, and are considered to be three times more effective than manual brushing. Water flossers are also useful for children with special healthcare needs.However, complete removal of plaque biofilm remains a challenge and depends on a child's manual dexterity, devices used, skills acquired through training, appropriate technique, and frequency of oral hygiene practice. With this background, the present study was undertaken to assess and compare the plaque removal efficiency of three interdental cleaning devices as an adjunct to brushing in children with mixed dentition.
Materials and methods: The present study was conducted by the Department of Pedodontics and Preventive Dentistry. A total of 308 children were screened, and 100 children aged 6-12 years with a minimum of 20 scorable teeth, free of systemic diseases and willing to participate with informed consent, were selected. Children with oral lesions, dental caries, or developmental disturbances of the teeth or systemic diseases affecting oral hygiene practices were excluded.At the initial visit, oral hygiene status was assessed and scored using the Rustogi Modified Navy Plaque Index (RMNPI) following standard protocols. Two-tone plaque disclosing solution was applied to all tooth surfaces using a cotton swab and left for 1 minute. Petroleum jelly was applied to the oral mucosa to prevent staining. After rinsing with water spray and suction for 30 seconds, plaque staining was evaluated. Each of the nine areas on buccal and lingual surfaces (including marginal and approximal regions) was scored, and the mean was calculated. Intraoral photographs were taken to reconfirm scores.Children were randomly divided into four groups of 25 each and trained in brushing and the use of interdental aids:Group I: Interdental floss (STIM flexible)Group II: Water flosser (Oracura-Prima)Group III: Interdental brush (STIM-Proxa angular brush)Group IV: Toothbrushing alone (Colgate Junior toothbrush)All groups practiced their assigned method for 4 weeks. Oral hygiene status was reassessed after 4 weeks using the same methodology. Data were tabulated in Microsoft Excel and analyzed using SPSS v22.0. Paired t-test was used for within-group comparison, analysis of variance (ANOVA) for between-group comparison, and Bonferroni test for multiple comparisons. A p-value of <0.05 was considered statistically significant.
Results: The results showed a significant reduction in plaque scores from baseline following toothbrushing (p = 0.000). No significant difference in plaque removal efficiency was observed between toothbrushing and flossing (p > 0.05), nor between floss, interdental brush, and oral irrigator (p > 0.05). However, oral irrigators and interdental brushes were significantly more effective than toothbrushing alone (p = 0.0087 and p = 0.0027, respectively).
Conclusion: Adjunctive aids such as dental floss, interdental brushes, and oral irrigators are recommended along with toothbrushing for better plaque control and prevention of caries and gingival diseases in children.
How to cite this article: George A, Mungara J, Vijayakumar P, et al. Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children. Int J Clin Pediatr Dent 2025;18(6):637-640.