Summary Review/Periodontal Disease
Evidence-Based Dentistry (2009) 10, 74. doi:10.1038/sj.ebd.6400666
The use of interdental brushes along with toothbrushing removes most plaque
Question: Are the use of interdental brushes (IDB) as an adjunct to toothbrushing more effective than toothbrushing alone?
Address for correspondence: DE Slot, Academic Centre for Dentistry Amsterdam, Department of Periodontology, Louwesweg 11066 EA, Amsterdam, The Netherlands. E-mail: d.slot@acta.nl
Graciela Rasines1
1Evidence-based Dentistry Commission, Dental Association of Argentina, Buenos Aires, Argentina
Slot DE, Dörfer CE, Van der Weijden GA The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review Int J Dent Hygiene 2008; 6: 253–264
Abstract
Data Sources
The National Library of Medicine (Washington DC; to access Medline-PubMed) and the Cochrane Central Register of Controlled Trials were searched for articles dated from 1965 up to November 2007.
Study selection
Two independent reviewers assessed studies for inclusion, aiming to identify appropriate randomised controlled clinical trials and controlled clinical trials. Studies were selected if they were conducted in humans, and included subjects of over 18 years of age in good general health with sufficient interdental space to use an interdental brushes. The articles were limited to English-language publications. Case reports, letters and narrative or historical reviews were excluded.
Data extraction and synthesis
As there was considerable heterogeneity in the design of the studies, a meta-analysis was only conducted for the comparison of the interdental brush with floss, with weighted mean differences (WMD) calculated using a random effects model. Descriptive comparisons were presented for brushing alone, brushing and flossing or brushing and woodsticks where appropriate.
Results
After searching the literature, 234 titles and abstracts required screening, resulting in 18 full-text articles. Based on the full texts, another five articles were excluded and finally nine studies were identified as eligible. Two were of crossover design, three of a split-mouth design and four were parallel design. The longest study duration was 12 weeks.
Conclusions
The evidence showed that interdental brush use as an adjunct to toothbrushing removes more dental plaque than brushing alone, being even more effective than dental floss or woodsticks in removing dental plaque. The evidence available for the effect on gingival inflammation is less conclusive. The reduction of pocket depth after the use of the interdental brush is more pronounced than with floss.
