Abstract
Optimisation of plaque control is essential for the success of non-surgical and surgical periodontal therapy. This cannot be achieved with brushing alone; hence, there is a need for adjunctive interdental cleaning aids. The aim of this paper is to provide an overview of different interdental cleaning aids and review the literature for consensus on their effectiveness. A literature search of articles in English, up to December 2018, was conducted in Pubmed. High-quality flossing is difficult to achieve, and ineffective routine use of floss may not confer significant benefits over brushing alone. Interdental brushes are more effective than brushing as a monotherapy. They are at least as good if not superior to floss in reducing plaque and gingivitis. Although they are effective for patients regardless of their periodontal status (healthy or active), they are especially indicated in periodontal patients where widened embrasures are common. Added benefits include ease of use, patient acceptance, and recontouring of interdental tissues. Rubberpiks do not demonstrate inferiority to conventional interdental brushes. Wooden interdental aids appear to offer no significant advantage over brushing with respect to plaque removal; they may, however, reduce gingival bleeding. Oral irrigators are a promising tool for reducing gingival inflammation, despite minimal changes to plaque levels. For cleaning around dental implants, oral irrigators and interdental brushes are preferred over floss.
Highlights
A patient’s ability to achieve good mechanical plaque control is vitally important
Scaling and root planing without effective plaque control during the healing/maintenance phase results in subgingival recolonisation within 4–8 weeks [1]
Good supragingival plaque control appears to be sufficient in preventing relapse or recurrence of the disease due to subgingival recolonization [2]
Summary
A patient’s ability to achieve good mechanical plaque control is vitally important. Scaling and root planing without effective plaque control during the healing/maintenance phase results in subgingival recolonisation within 4–8 weeks [1]. Good supragingival plaque control appears to be sufficient in preventing relapse or recurrence of the disease due to subgingival recolonization [2]. Toothbrushing is the most common method of mechanical plaque removal, we may still not be very good at it. A systematic review by van der Weijden et al found that, in adults with gingivitis, self-performed mechanical plaque removal with a manual toothbrush was not sufficiently effective [6]. The reality is that brushing alone may only remove up to 60% of overall plaque at each episode of cleaning [8]
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