The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review.

OBJECTIVES: The aim of this study was to assess systematically the adjunctive effect of both flossing and toothbrushing versus toothbrushing alone on plaque and gingivitis. MATERIALS: The MEDLINE and Cochrane Central register of Controlled Trials (CENTRAL) databases were searched through December 2007 to identify appropriate studies. The variables of plaque and gingivitis were selected as outcomes. RESULTS: Independent screening of titles and abstracts of 1166 MEDLINE-Pubmed and 187 Cochrane papers resulted in 11 publications that met the eligibility criteria. Mean values and SD were collected by data extraction. Descriptive comparisons are presented for brushing alone or brushing and flossing. A greater part of the studies did not show a benefit for floss on plaque and clinical parameters of gingivitis. A meta-analysis was performed for the plaque index and gingival index. CONCLUSIONS: The dental professional should determine, on an individual patient basis, whether high-quality flossing is an achievable goal. In light of the results of this comprehensive literature search and critical analysis, it is concluded that a routine instruction to use floss is not supported by scientific evidence.

The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review.

OBJECTIVE: To review the literature concerning cetylpyridinium chloride (CPC) containing mouth rinses as effective adjuncts to toothbrushing in the prevention of plaque accumulation and gingival inflammation. MATERIALS AND METHODS: Medline and the Cochrane Central Register of Controlled Trials were searched up to January 2008 to identify appropriate studies. The primary outcome measurements were plaque accumulation and gingivitis. RESULTS: Independent screening of titles and abstracts of 3250 papers resulted in eight publications that met the criteria of eligibility. Mean values and standard deviations were obtained by data extraction. Descriptive comparisons are presented for brushing only or brushing and rinsing. Meta-analyses were performed when possible. CONCLUSIONS: The existing evidence supports that CPC containing mouth rinses, when used as adjuncts to either supervised or unsupervised oral hygiene, provide a small but significant additional benefit in reducing plaque accumulation and gingival inflammation.