Minimal changes in daily flossing behavior among US adults from 2009 through 2020.

BACKGROUND: Flossing is considered to be an integral component of oral hygiene. The authors evaluated trends in daily flossing and their associations with sociodemographic variables. METHODS: The authors used data from the 2009-2020 National Health and Nutrition Examination Surveys, accounting for survey weights in all analyses. Descriptive statistics were computed for all study variables. Pooled univariable and multivariable logistic regression were performed to evaluate which sociodemographic factors were associated with daily flossing and to assess potential interactions with survey periods. Multivariable logistic regression was performed and stratified according to survey period. RESULTS: This study included 26,624 adults. Although the prevalence of daily flossing increased from 29.4% in 2009 through 2010 to 34.8% in 2017 through 2020, this increase was not significant after multivariable adjustment. Results of the pooled survey logistic regression also showed that participants who were older, female, Hispanic, and had a higher income to poverty ratio had higher odds of daily flossing. The interaction between education and survey period was significantly associated with daily flossing (P = .012). Logistic regression for each survey period corroborated the pooled model results. CONCLUSIONS: Approximately 1 in 3 adults in the United States reported flossing daily (32.7%). Although the prevalence of daily flossing increased from 2009 through 2020, this change was not significant after controlling for sociodemographic variables. PRACTICAL IMPLICATIONS: The nonsignificant changes in flossing behavior from 2009 through 2020 suggest that messaging to encourage adults to floss daily has had little effect. Although the authors did not elucidate the benefits of flossing, dental providers should continue to consider encouraging patients to floss until new evidence suggests otherwise.

Evaluating the Impact of Flossing Band Integration in Conventional Physiotherapy for Patellofemoral Pain Syndrome.

Background/Objectives: Patellofemoral Pain Syndrome (PFPS) is prevalent among physically active individuals, highlighting the need for innovative treatment strategies beyond conventional physiotherapy. This study investigates the effectiveness of integrating flossing band therapy with standard physiotherapy, anticipating improved outcomes in pain reduction, functional ability, and patient satisfaction. Methods: A double-blinded randomized controlled trial involved 50 PFPS-diagnosed participants. They were divided into two groups: Standard Physiotherapy Group (SPG) and Flossing Band and Physiotherapy Group (FBPG), each undergoing an 8-week intervention focusing on resistance training supplemented by respective therapies. Assessment metrics included pain (VAS), strength (Dynamometry), lower limb function (LEFS), and PFPS function (AKPS) measured before and after the intervention. Results: Significant enhancements in all outcome measures were noted for both groups, yet the FBPG exhibited notably superior improvements in pain, knee functionality, muscle strength, and lower extremity function. The FBPG demonstrated statistically significant greater efficacy in pain alleviation and strength enhancement. Conclusions: The addition of flossing band therapy to conventional physiotherapy presents a more effective treatment modality for PFPS, suggesting its potential to redefine therapeutic standards. Future studies should delve into the long-term impacts and mechanistic underpinnings of floss band therapy in PFPS management.

Comparison of the Impact of Two Interdental Cleaning Devices on the Reduction of Bleeding Around Implants.

Objective: Purpose: To evaluate the efficacy of water flossing to traditional flossing in lowering the bleeding on probing (BOP) index around dental implants. Methods and Materials: This single-center, examiner-masked research enrolled patients with implants and randomly allocated them to one of two groups. The research analyzed the effectiveness of manual toothbrushes when used with either string floss or a water flosser. Results: After 30 days, the main result was a decrease in BOP occurrence. At the outset, neither group had noticeably higher rates of bleeding than the other. While only six of 20 implants in the floss group demonstrated a decrease in BOP after 30 days, 18 of 20 implants in the water flosser group did. Conclusions: These results demonstrate that the use of water flossers was associated with much less bleeding than that of string floss. The researchers think that water flossing might be a useful addition to the maintenance of dental implants.

Efficacy of flossing and mouth rinsing regimens on plaque and gingivitis: a randomized clinical trial.

BACKGROUND: To investigate the effects of combinations of mechanical (brushing and flossing) and chemotherapeutic regimens which included essential oils (EO) non-alcohol and alcohol-containing mouthrinses compared to brushing only in the prevention and reduction of plaque, gingivitis, and gingival bleeding. METHODS: This was a randomized, virtually supervised, examiner blind, controlled clinical trial. Following informed consent and screening, subjects (N = 270) with gingivitis were randomly assigned to one of the following regimens: (1) Brush Only (B, n = 54); (2) Brush/Rinse (EO alcohol-containing mouthrinse) (BA, n = 54); (3) Brush/Rinse (EO non-alcohol containing mouthrinse) (BZ, n = 54); (4) Brush/Floss (BF, n = 54); (5) Brush/Floss/Rinse (EO non-alcohol containing mouthrinse) (BFZ, n = 54). Unflavored waxed dental floss (REACH unflavored waxed dental floss), and fluoridated toothpaste (Colgate Cavity Protection) were used. Examinations included oral hard and soft tissue, plaque, gingivitis, gingival bleeding, probing depth and bleeding on probing. RESULTS: After 12 weeks, both BA and BZ and the BFZ group were superior in reducing interproximal plaque (30.8%, 18.2%, 16.0%, respectively), gingivitis (39.0%, 36.9%, 36.1%, respectively), and bleeding (67.8%, 73.6%, 79.8%, respectively) compared to B. The BF group did not provide significant reductions in interproximal plaque but did reduce interproximal gingivitis (5.1%, p = 0.041) at Week 4 and bleeding at Weeks 4 and 12 (34.6%, 31.4%, p < 0.001 respectively) compared to B. The BFZ group did not significantly reduce interproximal plaque, gingivitis or bleeding compared to BZ. CONCLUSIONS: This study demonstrated that the addition of EO non-alcohol containing mouthrinse to the manual toothbrushing and flossing regimen further reduces plaque, gingivitis and bleeding showing that addition of EO mouthrinses (alcohol or non-alcohol containing) to the oral hygiene regimen provides sustained reductions in plaque to help maintain gingival health after a dental prophylaxis. Dental professional recommendation of the addition of an EO non-alcohol containing mouthrinse to daily oral hygiene routines of brushing or brushing and flossing should be considered to aid supragingival plaque control and improve gingivitis prevention. STUDY REGISTRY NUMBER: NCT05600231.

Effect of Floss Band on Anaerobic Exercise and Muscle Tissue Oxygenation.

CONTEXT: Flossing is still a relatively new technique that has yielded varied results in the research literature; therefore, it requires further investigation. Previous research has shown that thigh tissue flossing might improve performance in countermovement jump, sprint time, maximum voluntary contraction, and rate of force development. DESIGN: The present study aims to investigate the effect of the floss band on performance during the Wingate test (30-WAT), muscle oxygen saturation (SpO2), and total hemoglobin in vastus lateralis. METHODS: Twenty-two students of physical education and sport (11 men and 11 women) were randomly selected to complete either the Wingate test with the application of a floss band in warm-up or the Wingate test without the use of a floss band, followed by the alternative 24 hours apart. RESULTS: Throughout the testing, the floss band did not affect performance values during the Wingate test (relative peak power, relative average power, and fatigue index). However, there was a medium to large effect difference during 1 minute prior to 30-WAT (PRE), during the 30-WAT, and 10-minute recovery (REC) in values of SpO2 and total hemoglobin. Use of floss band displayed a higher SpO2 during PRE, 30-WAT, and REC by ∼13.55%, d < 2; ∼19.06%, d = 0.89; and ∼8.55%, d = 0.59, respectively. CONCLUSION: Collectively, these findings indicate that the application of thigh flossing during warm-up has no effect on 30-WAT performance; however, SpO2 was significantly increased in all stages of testing. This could lead to potential improvement in repeated anaerobic exercise due to increased blood flow. Increased muscle oxygen saturation can also lead to improved tissue healing as oxygen supply is essential for tissue repair, wound healing, and pain management.

Interdental cleaning aids are beneficial for oral health at 7-year follow-up: Results from the Study of Health in Pomerania (SHIP-TREND).

AIM: To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study. MATERIALS AND METHODS: We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation. RESULTS: Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs. CONCLUSIONS: Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.

Comparing the effectiveness of tissue flossing applied to ankle joint versus calf muscle on exercise performance in female adults: An observational, randomized crossover trial.

BACKGROUND: The prevalence of ankle sprains in females has higher than in males. A deficit in ankle dorsiflexion range of motion (DFROM) is a substantial contributor to ankle injuries, resulting in hampering exercise performance. Tissue flossing improves joint ROM and enhances performance. However, evidence of how floss band (FB) intervention influences the ankle joint and calf muscle is still lacking, particularly in women. We investigated comparing the effectiveness of FB applied to ankle joint versus calf muscle on exercise performance. METHODS: This study was a randomized, counterbalanced crossover trial. Eighteen recreationally women received functional movements without wrapping FB (WF), movements with wrapping the FB around the ankle joint (FAG), and movements with wrapping the FB around the calf muscle (FCM). Main outcome measures included ankle dorsiflexion range of motion (DFROM), pressure pain threshold (PPT), agility test before and 5 (POST5), 30 (POST30), and 60 (POST60) minutes after each of the three interventions in random order. Two-way repeated measures analysis of variance and effect size (Cohen's d) were statistically analyzed. RESULTS: FAG significantly increased ankle DFROM at POST5 (p = 0.01, d = 0.5), POST30 (p = 0.03, d = 0.48), and POST60 (p = 0.001, d = 0.75). FCM significantly increased at POST30 (p = 0.01, d = 0.35) and POST60 (p = 0.004, d = 0.37). Furthermore, FAG significantly improved agility at POST5 (p < 0.001, d = 0.39), POST30 (p = 0.004, d = 0.44), and POST60 (p = 0.007, d = 0.45); however, FCM only did at POST5 (p = 0.04, d = 0.29). The pressure pain threshold on the calf muscle did not significantly change. CONCLUSIONS: FAG and WF enhance ankle ROM and agility immediately. Moreover, FAG demonstrates a prolonged effect of agility for 1 h. Practitioners may take this information into account for choosing efficient applications.

The Acute Effect of Tissue Flossing on Pain, Function, and Perception of Movement: A Pilot Study.

Tissue flossing (TF) is a novel device that has been shown to cause peripheral compression and concurrent change in joint range of motion, perception of mobility and muscular performance. However, the effect of tissue flossing on pain, perception of mobility and function at the elbow joint has not been thoroughly investigated. The purpose of this pilot study was to examine the acute effect of TF on pain and upper extremity functional performance in subjects with musculoskeletal-related complaints of pain surrounding the elbow joint. We utilized a randomized crossover design. Nine resistance trained participants (8 men/1 woman) mean age 35.6 ± 10.7 took part in this study. We measured the following outcome measures; Pain Visual Analog Scale, Short Form McGill Pain Questionnaire II, pain-pressure threshold and hand grip dynamometry (HHD) pre and post and a Likert scale for movement ability questionnaire, posttest only, following a TF and placebo condition for each participant. TF resulted in significant improvement in all test measures, except HHD, pre to post (p ≤ 0.05). All pre to post changes were associated with large effect sizes for TF compared to the placebo condition applied to the elbow improves pain quality and intensity, perception of mobility and pain-pressure threshold in resistance trained individuals with a history of musculoskeletal pain for greater than 1 month. The results of this pilot study suggest that TF may function as an adjunct to treatment in the management of musculoskeletal pathologies at the elbow joint.

The Effect of Dental Flossing Instructions and Technique on Interproximal Bleeding: A randomized control trial.

Purpose Dental floss has been promoted reduce the effects from interdental microbial biofilm, however its efficacy has been questioned in the literature. The purpose of this study was to compare daily flossing instructions using an adapted horizontal vertical flossing technique (AHVFT) and routine oral hygiene on gingival inflammation as indicated by bleeding on probing (BoP).Methods This randomized single-blinded controlled clinical trial was conducted with non-smoking adults presenting with gingivitis and no other systemic diseases. Eligible participants were recruited from a dental school patient population and were randomly assigned to one of two groups. Group A (experimental group) was instructed in how to use the AHVFT once daily and Group B (control group) was asked to continue with their regular oral hygiene practices. Clinical evaluations (interproximal BoP measurements) were performed by blinded, calibrated examiners at two, four, and eight-week intervals; the percentage of sites with interproximal BoP was recorded. Descriptive and inferential statistics were used to analyze the data.Results A total of 36 eligible participants were enrolled in the study: Group A (n=18), Group B (n=18). The mean (±SD) percentage of interproximal sites with BoP was 26.3 (±4.7), 8.6 (±7.3), 7.2 (±5.2), and 7.9 (±5.8) for Group A at baseline, two weeks, four weeks, and eight weeks, respectively. The corresponding values for Group B were 25.8 (±9.9), 15.6 (±12.4), 12.3 (±12.2), and 18.0 (±13.1), respectively. The percentage of sites with BoP was significantly lower for Group A than for Group B (p=.015 at two weeks, p=.009 at four weeks, and p<.001 at eight weeks). Within each group, the percentage of sites with BoP was significantly lower when compared with baseline (p<.008). At the final visit, the percent reduction in BoP for Group A was 70% and 30% for Group B compared with baseline. Most (88.2%) of Group A participants demonstrated mastery of the AHVFT at eight weeks.Conclusion Participants who received Instruction with the daily use of the AHVFT were shown to have reductions in interproximal BoP as compared to participants who had not received instructions in the AHVFT. Positive gingival health outcomes with dental flossing may be technique sensitive.

Effects of water flossing on gingival inflammation and supragingival plaque microbiota: a 12-week randomized controlled trial.

OBJECTIVES: The effects of water flossing on dental plaque removal have been suggested, but its ecological impact on dental plaque microbiota needs further investigation. In addition, whether this plaque control measure by water flossing promotes the control of halitosis still needs clinical validation. The aim of this study was to evaluate the effects of water flossing on gingival inflammation and supragingival plaque microbiota. MATERIALS AND METHODS: Seventy participants with gingivitis were randomly assigned to control (toothbrushing) and experimental (toothbrushing + water flossing) groups (n = 35). Participants were recalled at 4, 8, and 12 weeks, and their gingival index, sulcus bleeding index, bleeding on probing, dental plaque index, and oral malodor values were measured. The microbiota of supragingival plaque was further investigated using 16S rRNA sequencing and qPCR. RESULTS: Sixty-three participants completed all revisits (control: n = 33; experimental: n = 30). The experimental and control groups exhibited similar clinical characteristics and dental plaque microbiota at baseline. Adjunctive water flossing effectively reduced the gingival index and sulcus bleeding index as compared to the toothbrushing control group. The water-flossing group showed reduced oral malodor at week 12 as compared to the baseline. Consistently, the water-flossing group exhibited altered dental plaque microbiota at week 12, characterized by a depletion of Prevotella at genus level and Prevotella intermedia at species level as compared to the toothbrushing control. In addition, the plaque microbiota of water-flossing group exhibited a more aerobic phenotype, while the control group was more anaerobic. CONCLUSIONS: Daily water flossing can effectively alleviate gingival inflammation and reduce oral malodor, possibly by depleting oral anaerobes and altering the oral microbiota to a more aerobic phenotype. CLINICAL RELEVANCE: Water flossing adjunctive to toothbrushing effectively alleviated gingival inflammation, representing a promising oral hygiene practice to promote oral health. CLINICAL TRIAL REGISTRATION: The trial was registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/showprojen.aspx?proj=61797 , #ChiCTR2000038508) on September 23, 2020.

Predicting Flossing through the Application of the Multi-Theory Model (MTM) of Health Behavior Change among Minority Adolescents in the United States.

Adolescents from minority groups are particularly susceptible to poor oral hygiene behaviors, including lack of daily flossing. This cross-sectional study aimed to conduct an exploratory behavioral research to identify evidence-based (theory-based) approaches to promote flossing behavior among African American/Black and Latinx/Hispanic (minority) adolescents. A 39-item psychometrically valid web-based questionnaire was used to collect responses from a nationwide sample of minority adolescents aged 10-17 years residing in the United States. The data were analyzed using bivariate and multivariate statistical methods. Of 520 minority adolescents (260 African American/Black and 260 Latinx/Hispanic adolescents), the proportion of flossing was nearly equally split in the sample. A significantly higher proportion of minority adolescents who were flossing had access to floss as opposed to those who were not flossing (86.8% vs. 69.8%, p < 0.001). A significantly higher proportion of minority adolescents who were not flossing did not visit the dentist over the past year as opposed to those who floss (25.2% vs. 14.7%, p < 0.001). Among the participants who were not flossing, gender, grade level, instruction in school regarding flossing, and multi-theory model (MTM) of health behavior change constructs were the significant predictors (p < 0.001) of initiating and sustaining flossing. The findings of this study will serve as baseline data for developing and evaluating effective evidence-based interventions using the MTM.

Flossing technique for endovascular repair of a penetrating cerebrovascular injury: illustrative case.

BACKGROUND: A teenage boy who had been stabbed in the neck presented with an extracranial traumatic functional carotid artery occlusion that could not be crossed in an antegrade fashion. Endovascular repair depends on obtaining catheter access proximal and distal to an injury within the true lumen. OBSERVATIONS: The occlusion was treated with flossing technique via the posterior communicating artery. After successful recanalization from a retrograde approach, the carotid artery occlusion was treated with a covered stent. LESSONS: The flossing technique is well established in peripheral vascular disease and may be beneficial in certain cases in the neck vasculature when antegrade access is difficult to obtain. Recanalization of an occluded carotid artery from retrograde approach may be successful in cases of trauma from knife wounds.

Effectiveness of Warm-Up Exercises with Tissue Flossing in Increasing Muscle Strength.

Tissue flossing is an increasingly popular method in physiotherapy and sports. There is a belief that tissue flossing can improve range of motion and muscle strength, shorten muscle recovery time, and reduce the risk of injury. The aim of this study was to analyse the effectiveness of tissue flossing for immediately improving muscle strength in recreational athletes when it is performed during warm-up. All participants were randomly assigned to either an experimental group (n = 36) or a control group (n = 34) using a random number generator. The experimental group (n = 36) performed an intervention comprising exercises with muscle tissue flossing and exercises without flossing. The control group (n = 30) performed the same protocol without a floss band. Muscle strength was measured for knee flexion end extension at three speeds (60, 120, and 180 °/s) 3 times. Analysed parameters include peak torque, work, and power related to body weight, flexors−extensors ratio, and time to peak torque. There were no significant changes in the muscle strength parameters from before to after the warm-up in either group (p > 0.05). Significantly lower values of peak torque, work, and power were observed in the experimental group during the warm-up with the floss band applied to muscles (p < 0.05). No clinically significant changes in time to peak torque or flexors−extensors ratio were observed. A single application of flossing does not improve muscle strength or power and can even reduce individuals' maximum muscle strength capabilities.

Effect of Blood Flow Restriction Technique on Delayed Onset Muscle Soreness: A Systematic Review.

Background and Objectives: The effect of the blood flow restriction technique (BFR) on delayed onset muscular soreness (DOMS) symptoms remains unclear. Since there is no consensus in the literature, the aim of the present study is to systematically identify and appraise the available evidence on the effects of the BFR technique on DOMS, in healthy subjects. Materials and Methods: Computerized literature search in the databases Pubmed, Google Scholar, EBSCO, Cochrane and PEDro to identify randomized controlled trials that assessed the effects of blood flow restriction on delayed onset muscular soreness symptoms. Results: Eight trials met the eligibility criteria and were included in this review, presenting the results of 118 participants, with a mean methodological rating of 6/10 on the PEDro scale. Conclusions: So far, there is not enough evidence to confirm or refute the influence of BFR on DOMS, and more studies with a good methodological basis are needed, in larger samples, to establish protocols and parameters of exercise and intervention. Data analysis suggests a tendency toward the proinflammatory effect of BFR during high restrictive pressures combined with eccentric exercises, while postconditioning BFR seems to have a protective effect on DOMS. Prospero ID record: 345457, title registration: "Effect of Blood Flow Restriction Technique on the Prevention of Delayed Onset Muscle Soreness: A Systematic Review".

Hemodynamic Responses to Resistance Exercise with Blood Flow Restriction Using a Practical Method Versus a Traditional Cuff-Inflation System.

The aim of this study was to examine the potential differences in acute hemodynamic responses and muscular performance outcomes following resistance exercise between traditional blood flow restriction (TRABFR) and a novel band tissue flossing method (BTFBFR). METHODS: Fifteen healthy young adults (23.27 ± 2.69 years) visited the lab for three sessions (≥72 h apart). Each session's exercise consisted of three sets of 20 maximum-effort seated leg extensions and flexions with one of three conditions: control (CON), TRABFR (50% limb occlusion pressure (LOP)), or BTFBFR. During TRABFR and BTFBFR sessions, occlusion was applied immediately prior to exercise and removed immediately after. Heart rate was collected prior to exercise, after onset of occlusion, immediately after exercise, and one-minute after removal of occlusion. Ultrasonography was performed prior to, and at least 30 s after, occlusion. RESULTS: BTFBFR caused greater reductions in arterial distance (14.28%, p = 0.010) and arterial area (28.43%, p = 0.020) than TRABFR. BTFBFR was able to significantly reduce arterial flow below pre-occlusion values, while TRABFR did not. Both conditions caused significant elevations in heart rate following occlusion (TRABFR: +4.67 bpm, p = 0.046 and BTFBFR: +6.07 bpm, p = 0.034), immediately post-exercise (TRABFR: +56.93 bpm, p < 0.001 and BTFBFR: +52.79 bpm, p < 0.001) and one-minute post-exercise (TRABFR: +15.71, p = 0.003 and BTFBFR: +14.57, p < 0.001). Only BTFBFR caused significant reductions in performance as measured by average power per repetition. CONCLUSIONS: BTFBFR causes a more exaggerated decrease in arterial blood flow as well as muscular power when compared to traditional TRABFR at 50% of LOP.

Delay discounting, probability discounting, and interdental cleaning frequency.

BACKGROUND: Interdental cleaning is recommended by dentists but many people do not floss regularly. The health benefits of interdental cleaning are delayed, and sensitivity to delay is an important factor in many health behaviors. Thus, the present studies explore the relationship between frequency of flossing, and sensitivity to delayed and probabilistic outcomes. METHOD: Crowd-sourced subjects were recruited in two studies (n = 584 and n = 321, respectively). In both studies, subjects reported their frequency of flossing and completed delay discounting and probability discounting tasks. Discounting was measured with area under the curve, and linear regression was used to analyze the results. RESULTS: Findings show that higher levels of delay discounting were associated with less frequent flossing (p < 0.001, both studies). In contrast, probability discounting was not significantly associated with flossing frequency (ns, both studies). CONCLUSION: The findings are consistent with prior studies involving other health behaviors such as attendance at primary care and medication adherence. Results suggest that interventions that reduce delay discounting may help promote regular interdental cleaning, and that delay discounting is a more robust predictor of health behaviors than probability discounting. In addition, interdental cleaning appears to be a reasonable target behavior for evaluating potentially generalizable behavioral health interventions. Thus, interventions that are successful in promoting oral health behaviors should be considered as candidates for evaluation in other health behavior domains.

Comparative Effectiveness of Toothbrushing, Flossing and Mouthrinse Regimens on Plaque and Gingivitis: A 12-week virtually supervised clinical trial.

Purpose:Various mechanical and chemotherapeutic methods are used to control dental plaque accumulation and prevent or reduce gingivitis. The purpose of this 12-week clinical trial was to investigate the effects of various combinations of supervised mechanical and chemotherapeutic regimens on the prevention and reduction of plaque, gingivitis, and gingival bleeding.Methods:Volunteers presenting with some evidence of gingivitis and no severe periodontitis were randomized into four groups: brush only (BO); brush/rinse (BR); brush/floss (BF); brush/floss/rinse (BFR) for this examiner-blinded clinical trial. Toothbrush, toothpaste, floss and a mouthrinse containing a fixed combination of four essential oils (EO) and training/instructions were provided to participants as per their assigned group. Participants performed their regimen at home, under virtual supervision, once each weekday; the second daily and weekend uses were unsupervised. Assessments included oral hard and soft tissue, plaque, gingivitis, and gingival bleeding (weeks 4, 12); probing depth and bleeding on probing (week 12).Results:Of 213 enrolled participants, 209 completed the study. After 12 weeks, plaque, gingivitis, and gingival bleeding were significantly reduced in groups BR (35.8%, 50.8%, and 71.0% respectively, p<0.001) and BFR (32.8%, 54.1%, and 78.2% respectively, p<0.001) compared to BO. After 12 weeks, gingivitis and gingival bleeding were significantly reduced in the BF group (9.2%, p=0.013 and 17.5%, p=0.003, respectively), however there were no significant reductions in plaque in the BF group as compared to the BO group (p=0.935).Conclusions:Oral care regimens that included a mouthrinse containing a fixed combination of four EOs (BR and BFR), demonstrated statistically significantly reduced plaque, gingivitis, and gingival bleeding as compared to BO and BF after 12 weeks. The BF regimen statistically significantly reduced gingivitis and gingival bleeding but did not statistically significantly reduce plaque compared to BO after 12 weeks.

Role of Manual Dexterity on Mechanical and Chemotherapeutic Oral Hygiene Regimens.

Purpose:Effective use of mechanical plaque control devices can depend on individual manual dexterity levels. The purpose of this component of a 12-week, virtually-supervised clinical trial was to investigate the role of manual dexterity on clinical outcomes for gingivitis, as measured by the relationship between manual dexterity scores on the Purdue Pegboard Test (PPT) and the effects of various mechanical and chemotherapeutic oral hygiene regimens.Methods:This was a single-center, examiner blinded, randomized, four-treatment arm, parallel group, 12-week plaque and gingivitis study. At baseline, healthy adult volunteers with evidence of gingivitis were assessed for manual dexterity and were then examined for plaque, gingivitis and bleeding. After a dental prophylaxis, participants were randomized into four treatment groups: brush only (BO); brush/rinse (BR); brush/floss (BF); and brush/floss/rinse (BFR). The flossing groups received instruction in flossing. The PPT was used to assess manual dexterity and was performed by a licensed occupational therapist. Virtual supervision was required once each weekday and the oral hygiene regimen was unsupervised on evenings and weekends.Results:Of the 213 subjects enrolled, 209 completed the trial. Improvements from baseline to week 12 in interproximal percent nonbleeding healthy sites (Expanded Bleeding Index (EBI)=0 and Modified Gingival Index (MGI)=0 or 1) were dependent on the participant's dexterity score. Participants with the lowest dexterity scores (9 or lower) in the BFR treatment group demonstrated the greatest improvement interproximally based on the indices (EBI and MGI). In comparison, the BF test group subjects with dexterity scores 9 or lower had limited change in improvement interproximally. There was a direct correlation between flossing effectiveness and dexterity scores.Conclusions:Less manual dexterity can limit dental flossing effectiveness. Flossing is a difficult daily task that requires functional bilateral dexterity to be perform correctly. Individuals with lower levels of manual dexterity were shown to benefit from the addition of an essential oil mouthrinse to a regimen of toothbrushing and flossing in this clinical trial. The addition of an essential oil mouthrinse improved interproximal gingival health and mitigated the manual dexterity variable.

Effect of Neurodynamics Nerve Flossing on Femoral Neuropathy in Haemophilic Patients: A randomized controlled study.

OBJECTIVE: Heamophilia is considered a disorder in both children and adolescents which may affect their quality of life seriously than their normal peers; this study investigated the impact of the Neurodynamics Nerve Flossing Technique (NFT) on femoral neuropathy in patients with haemophilia. METHOD: Thirty haemophilic children with Femoral Neuropathy were randomly allocated into two equivalent groups; the study group which received Neurodynamics NFT of the femoral nerve and conventional therapy program, and the control group which received only the conventional therapy program, three sessions/week for 12 weeks. Femoral nerve motor conduction velocity (MCV) and level of pain sensation according to the Visual Analogue Scale (VAS), were assessed pre and post interventions. RESULTS: post-treatment comparison between both groups revealed that there was a significant increase in femoral nerve MCV and reduction of pain sensation of the study group compared to the control group (p<0.05). CONCLUSION: Neurodynamics Nerve flossing had a clear effect in the treatment of femoral neuropathy in children with haemophilia.

Medical Flossing and the Pilates Method: Their Effectiveness on the Strength, Endurance, and Functionality of Healthy Individuals.

The flossing method is an emerging therapeutic intervention based on the use of a floss-band that is circumnavigated at the various points of the body being treated. It is optimally combined with an appropriate exercise program to induce ischemia and release the fascia by applying pressure and movement to functional models. The Pilates method teaches the person to focus on the muscles, especially those responsible for the correct posture. It also helps the individual to become aware of the way he/she breathes. Both methods have positive effects on exercise and rehabilitation. However, medical flossing has not been as well researched as the Pilates method. This study aims to examine the effectiveness of both methods on the strength, endurance, and functionality of healthy individuals. A review of the literature on medical flossing and Pilates was conducted. A systematic research took place from 2014 to 2019. Publications in non-English or non-Greek language were excluded. The articles were retrieved from not only PubMed, Scielo, and Elsevier databases, but also Google Scholar. Both methods are understudied in relation to their effectiveness on the strength, endurance, and functionality of healthy individuals. More studies are required to estimate the effects of both methods on healthy individuals.