The effectiveness of dental floss in on plaque and limitations of gingival infection
It is generally accepted that bacterial plaque is an important aetiological factor of periodontal diseases. Despite recent
Advances in oral chemotherapeutics, mechanical removal of plaque remains the primary method for controlling supra- gingival accumulations. The most common method of mechanical plaque control is tooth brushing. Tooth brushing alone, however, does not reach the interproximal areas of the dentition, which means that part of the dentition is left unclean. The interdental areas, especially the posterior, are the least accessible. For this reason, soft and ⁄ or hard deposits accumulate in the space between teeth in almost all patients. Periodontal and gingival lesions are predominantly observed at these sites. As the interproximal areas of the dentition are also frequently affected by caries, interproximal cleaning represents an important aspect of oral self-care. Patients should therefore resort to additional techniques to tooth brushing. A wide variety of interdental cleaning devices are available. For the most part, the most appropriate interdental aid depends on the size and shape of the interdental space, as well as the morphology of the proximal tooth surface. Also, the level of dexterity and ability of the patient to use a hygiene aid should be taken into account. As a method to remove interproximal plaque, flossing has received the most attention. However, the difficulty in flossing probably makes this technique less than universal in its application. Over the years, it has been generally accepted that dental floss has a positive effect on removing plaque. The American Dental Association (ADA) even reports that up to 80% of plaque may be removed by this method. Several reviews have been conducted on the efficacy of manual flossing, flossing aids and devices and other interdental cleansing aids. However, few reviews are systematic and none of them has conducted a meta-analysis. Also, a limited number of studies provide data on the effectiveness of flossing and tooth brushing compared to tooth brushing alone. Many studies compare floss with another interdental aid. Warren et al. wrote that studies that have compared flossing with tooth brushing have found that their combined use produces no clear benefit. Jahn stated that practitioners often perceive flossing as superior to other methods of interdental cleaning, while research has not proven this. Additionally, a recent review showed that self-flossing has no effect on reducing caries risk.
Journal of Oral Hygiene and Health