title: Comparison of the use of a toothpick holder to dental floss in improvement of gingival health in humans.
abstract: BACKGROUND
  Although advances have been made in modulation of host inflammatory response in periodontal therapy, it is important to control the bacterial challenge to the host immune system through conventional therapy and improvement of personal oral hygiene. Although toothbrushing is generally performed, interdental cleaning is not as common. This study compared the use of dental floss to a toothpick holder in the improvement of gingival health.
  
  
  METHODS
  Participants were examined and those with clinical gingivitis or slight chronic periodontitis were included in the study. O'Leary plaque, interproximal plaque index (IPI), and Eastman interdental bleeding index scores (EIBI) were recorded at baseline and following appointments. Forty-two females and 13 males ranging from 18 to 50 years in age were randomly divided into either a dental flossing group or toothpick holder using group. Each was given instructions in the use of the oral hygiene device and examined 2, 6, and 12 weeks following baseline. At 12 weeks, 27 floss users and 20 toothpick-holder users completed the study.
  
  
  RESULTS
  Plaque scores were reduced in both groups as the study progressed. Mean O'Leary plaque scores decreased significantly for both methods from baseline to week 12 (P < 0.05). The EIBI and IPI scores decreased in mean scores over time for each method (P < 0.05). A correlation was found between the O'Leary plaque index and the IPI scores (P < 0.05).
  
  
  CONCLUSIONS
  The results of this study found that the use of dental floss or toothpick holder resulted in no significantly different effect in the improvement of gingival health.
authors.affiliation: Department of Restorative Dentistry, Division of Operative Dentistry, University of Tennessee College of Dentistry, Memphis, TN 38163, USA.
authors.forename: Maurice W
authors.initials: MW
authors.lastname: Lewis
authors.forename: Cassandra
authors.initials: C
authors.lastname: Holder-Ballard
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Selders
authors.forename: Mark
authors.initials: M
authors.lastname: Scarbecz
authors.forename: Howard G
authors.initials: HG
authors.lastname: Johnson
authors.forename: Edgar W
authors.initials: EW
authors.lastname: Turner
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D005260:Female; D005891:Gingivitis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene / Q000295:instrumentation*; D010512:Periodontal Index; D014099:Toothbrushing / Q000295:instrumentation