Efficacy of the Use of a Water Flosser in Addition to an Electric Toothbrush on Clinical Signs of Inflammation: 4-Week Randomised Controlled Trial
Lyle DM, Goyal CR, Qaqish JG, Schuller R. Compend Contin Ed Dent 2020; 41(3):170–177. Epub Jan 1, 2020.
Objective
To determine the incremental efficacy of adding a Waterpik Water Flosser to a high-end Oral-B® electric toothbrush in reducing plaque and gingivitis, compared to brushing alone with the electric toothbrush.
Methodology
Seventy subjects completed this four-week, randomised controlled trial. Participants were assigned to one of two groups:
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Group 1: Waterpik Water Flosser plus Oral-B® Pro 2000 with Precision Clean brush head (WF).
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Group 2: Oral-B Pro 2000 with Precision Clean brush alone (OR).
Gingivitis was measured using Bleeding on Probing (BOP) and the Modified Gingival Index (MGI), while plaque was evaluated using the Rustogi Modification of the Navy Plaque Index (RMNPI).
Data were collected at baseline, two weeks, and four weeks. All subjects were provided with manufacturer instructions for correct product use.
Results
Both groups showed a significant reduction from baseline in BOP, MGI, and RMNPI at two and four weeks (p<0.001).
After four weeks, the WF group demonstrated superior improvements across all parameters, achieving:
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37% greater reduction in BOP
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36% greater reduction in MGI
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33% greater reduction in RMNPI
compared to brushing alone with the Oral-B Pro 2000.
Conclusion
Adding a Waterpik Water Flosser to a high-quality oscillating electric toothbrush regimen provides significantly greater improvements in plaque removal and gingival health than brushing alone.