title: Assessment of treatment responses to dental flossing in twins.
abstract: BACKGROUND
  The purpose of this study was to assess treatment responses to dental flossing in twins.
  
  
  METHODS
  The study was a two-treatment, examiner-blind, randomized parallel group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2-week supervised and unsupervised treatment regimen consisting of 1) tongue brushing and toothbrushing (TB) and 2) TB + flossing (TB + Fl). Clinical endpoints were gingival bleeding (papillary bleeding score [PBS]) and oral malodor (levels of volatile sulfur compounds [VSC]). Analysis of variance and covariance methodologies were employed to analyze the data.
  
  
  RESULTS
  Baseline average PBS values were 1.352 and 1.345 for the TB + Fl and TB groups, respectively (P=0.937). After 2 weeks of treatment, the TB + Fl group had a statistically significant decrease in PBS values of 0.558 (41.5% versus baseline), whereas the TB group showed no improvement from baseline. The change from baseline for the TB + Fl group was superior to that for the TB group (P<0.001). Similar findings were observed for the number of baseline papillary bleeding sites. Baseline average intraoral halimeter values were 45.91 and 41.75 for the TB+Fl and TB groups, respectively (P=0.504). Both treatment regimens demonstrated highly statistically significant reductions in intraoral halimeter values versus baseline (all P<0.001) and the difference between treatment groups was not statistically significant (P=0.339). Similar findings were found for expired air.
  
  
  CONCLUSIONS
  In a well-matched twin cohort, tongue and toothbrushing plus flossing significantly decreased gingival bleeding after 2 weeks.
authors.affiliation: Procter & Gamble, Cincinnati, OH, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Biesbrock
authors.forename: Patrick M A
authors.initials: PM
authors.lastname: Corby
authors.forename: Robert
authors.initials: R
authors.lastname: Bartizek
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Corby
authors.forename: Mania
authors.initials: M
authors.lastname: Coelho
authors.forename: Simone
authors.initials: S
authors.lastname: Costa
authors.forename: Walter A G
authors.initials: WA
authors.lastname: Bretz
authors.forename: Walter A
authors.initials: WA
authors.lastname: Bretz
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001944:Breath Tests; D002648:Child; D003742:Dental Devices, Home Care; D005260:Female; D005891:Gingivitis / Q000628:therapy*; D006209:Halitosis / Q000628:therapy*; D006801:Humans; D008297:Male; D010512:Periodontal Index; D016037:Single-Blind Method; D014099:Toothbrushing