Assessment of Treatment Responses to Dental Flossing in Twins

Abstract

The purpose of this study was to assess treatment responses to dental flossing in twins. The study was a two-treatment, examiner-blind, randomized parallel group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2-week supervised and unsupervised treatment regimen consisting of 1) tongue brushing and toothbrushing (TB) and 2) TB + flossing (TB + Fl). Clinical endpoints were gingival bleeding (papillary bleeding score [PBS]) and oral malodor (levels of volatile sulfur compounds [VSC]). Analysis of variance and covariance methodologies were employed to analyze the data. Baseline average PBS values were 1.352 and 1.345 for the TB + Fl and TB groups, respectively (P=0.937). After 2 weeks of treatment, the TB + Fl group had a statistically significant decrease in PBS values of 0.558 (41.5% versus baseline), whereas the TB group showed no improvement from baseline. The change from baseline for the TB + Fl group was superior to that for the TB group (P<0.001). Similar findings were observed for the number of baseline papillary bleeding sites. Baseline average intraoral halimeter values were 45.91 and 41.75 for the TB+Fl and TB groups, respectively (P=0.504). Both treatment regimens demonstrated highly statistically significant reductions in intraoral halimeter values versus baseline (all P<0.001) and the difference between treatment groups was not statistically significant (P=0.339). Similar findings were found for expired air. In a well-matched twin cohort, tongue and toothbrushing plus flossing significantly decreased gingival bleeding after 2 weeks.