Comparing Effectiveness Of Plaque Removal Of Three Different Interproximal Devices

Objective: The objective of this study was to determine whether or not the toothpick and/or interdental brush are equal in effectiveness to floss in removing supragingival interproximal plaque when patient compliance and device ease of use, as experimental variables, were removed. Methods: Male and female student healthcare volunteers from Loma Linda University 20-35 years of age of any ethnicity in general normal health and general good oral health participated with interdental papillae filling the embrasures were included in the study. All subjects were given a standardized full mouth prophylaxis and were instructed to abstain from interproximal hygiene for two weeks. After two weeks of plaque accumulation, interproximal plaque was removed using floss, interproximal brush and the toothpick in their designated quadrants. Using Turesky's modification of Quigley and Hein, plaque scores were recorded before and after interproximal plaque removal. The difference between the two plaque scores was analyzed and the effectiveness of the devices was compared. Results: Data was analyzed using Kruskal-Wallis rank test and Mann-Whitney U test at the significance level of a= 0.05. Our results indicate that toothpick is significantly less effective in removing plaque than floss and interproximal brush (p<0.0001 and p=0.001 respectively). There was no significant difference in plaque removal between toothpick and control (p=0.051). And finally, there is no significant difference in plaque removal between floss and interproximal brush (p=0.957). Conclusion: Since they are equally effective in plaque removal, interproximal brush is an alternative to floss when the patient dexterity or wiliness to use the floss is compromised. When papillae fill the interproximal space, toothpick is not very effective and floss or interproximal brush should be advised.