Water Flossers Preferred Over String Floss.

Despite the focus on evidence-based decision making, some of the concepts used to indoctrinate dental and dental hygiene students lack scientific evidence. Dental floss is a good example. Dental floss continues to be part of the foundation message of disease prevention put out by both dental and dental hygiene associations and educational institutions.

Evidence is lacking that dental floss will reduce tooth decay or gingivitis when added to routine toothbrushing. Hygienists have been talking about floss for 100 years, yet the number of people who floss daily is surprisingly low: 10 to 30 percent. Despite these statistics and the availability of alternatives to dental floss for cleaning between the teeth, hygienists continue to push floss.

Other alternatives are available to disrupt Interdental biofilm. One hygienist wanted to know if she could impact patient oral health by promoting the water flosser rather than traditional string floss for those who would not floss. The alternative to string floss was introduced to 10 patients who were all willing to try something other than string floss. This small pilot study followed up with the patients 10 days after their regular dental hygiene visit where the water flosser was introduced.

The patients all purchased a water flosser either from the dental practice or a retail store. Compliance was good, likely due to the novelty of the water flosser. Bleeding and probing depths were shallower at 10 days, which is to be expected following a dental hygiene visit. This study showed that patients are open to alternatives to string floss. Follow-up will determine if long term compliance is achieved.


Clinical Implications: For patients who can't or won't use string floss, suggest water flossing.

Flint, K.: Can Water Flossing be Promoted to Patients Over String Floss, Lead to Improved Oral Health. OHU Action Research, 3A-14, 2014