title: Clinical efficacy of flossing versus use of antimicrobial rinses.
abstract: BACKGROUND
  Dental floss is only used by a small part of the population on a daily basis. Therefore, an easy, applicable alternative is needed. This alternative could be a mouthrinse with antimicrobial activity for daily use. The aim of the present study was to evaluate the efficacy of two mouthrinses in reducing interdental plaque and gingivitis compared to dental floss.
  
  
  METHODS
  A total of 156 healthy volunteers were randomly assigned to the following groups: 1) toothbrushing and rinsing (0.06% chlorhexidine and 0.025% fluoride); 2) toothbrushing and rinsing (0.1% cetylpyridiniumchloride and 0.025% fluoride); 3) toothbrushing and flossing; and 4) toothbrushing only (N = 39 subjects in each group). At baseline, the modified proximal plaque index (MPPI) and papillary bleeding index (PBI) were recorded. Thereafter, subjects had to brush in the usual manner during 8 weeks. Additionally, test groups had to rinse once a day (groups 1 and 2: 30 seconds) or to floss (group 3). Eight weeks after baseline, indices were recorded again and improvements were calculated. Analysis of variance (ANOVA) and the Bonferroni test served for statistical analysis.
  
  
  RESULTS
  After 8 weeks, reductions for all indices were found in all groups (P <0.05). With respect to the MPPI, mouthrinse groups performed better than the control and floss groups: 1) 0.73; 2) 0.82; 3) 0.40; and 4) 0.32 (P <0.05). The PBI showed no statistically significant difference between groups: 1) 0.46; 2); 0.50; 3); 0.42; and 4) 0.37.
  
  
  CONCLUSIONS
  The results suggest that, in combination with toothbrushing, daily use of the tested mouthrinses may result in a higher interproximal plaque reduction than daily flossing.
authors.affiliation: Department of Operative and Preventive Dentistry and Endodontics, Heinrich-Heine-University of Duesseldorf, Dusseldorf, Germany. zimmer@med.uni-duesseldorf.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Zimmer
authors.forename: Claudia
authors.initials: C
authors.lastname: Kolbe
authors.forename: Gerrit
authors.initials: G
authors.lastname: Kaiser
authors.forename: Tracy
authors.initials: T
authors.lastname: Krage
authors.forename: Michelle
authors.initials: M
authors.lastname: Ommerborn
authors.forename: Claudia
authors.initials: C
authors.lastname: Barthel
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002594:Cetylpyridinium / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use*; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000628:therapy*; D003774:Dental Plaque Index; D005260:Female; D005891:Gingivitis / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D016037:Single-Blind Method; D012969:Sodium Fluoride / Q000627:therapeutic use; D014099:Toothbrushing; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D012969:Sodium Fluoride; D002594:Cetylpyridinium; D002710:Chlorhexidine