title: Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances.
abstract: BACKGROUND
  Effective self-care is difficult for people with orthodontic appliances because of the inherent design of brackets and archwires. It is not uncommon to have increases in plaque and gingivitis after placement of fixed appliances. The purpose of this study was to evaluate the effect of using a dental water jet (DWJ) with a specialized tip (orthodontic) on plaque and bleeding in adolescent orthodontic patients with fixed appliances.
  
  
  METHODS
  One hundred six subjects were enrolled in this single blind, parallel clinical study. They were randomly assigned to 1 of 3 treatment groups: group 1, once daily irrigation with a DWJ and orthodontic jet tip plus a manual toothbrush; group 2, once daily flossing (FL) plus a manual toothbrush; group 3, manual toothbrush (MT) only. Plaque index (PI) and bleeding index (BI) scores were recorded at baseline, and at 2 and 4 weeks.
  
  
  RESULTS
  All groups showed statistically significant reductions in PI (whole mouth and interproximal) at 2 and 4 weeks (P <.001). In group 1, the DWJ was statistically more effective at reducing whole-mouth and interproximal plaque than the methods in the other groups (P >.001) at both 2 and 4 weeks, whereas the FL protocol in group 2 was significantly more effective than the MT protocol in group 3 at 4 weeks (P =.025) for whole-mouth plaque and at 2 and 4 weeks (P = .011 and P = .028, respectively) for interproximal plaque. All groups showed statistically significant reductions in BI (whole mouth and interproximal) at 2 and 4 weeks (P <.001). The DWJ in group 1 was statistically more effective at reducing whole-mouth bleeding than the protocols of the other groups at 2 and 4 weeks (P <.001), and the FL was statistically more effective than the MT at both times (P <.001). Both the DWJ and the FL were significantly more effective than the MT at 2 weeks (P <.001 and P <.016, respectively) for interproximal bleeding, but there were no differences between the groups at 4 weeks.
  
  
  CONCLUSIONS
  A DWJ with a specialized orthodontic jet tip is effective for adolescents in fixed orthodontic appliances; it demonstrated beneficial results for the reduction of plaque and bleeding.
authors.affiliation: BioSci Research Canada Ltd., Mississauga, Ontario, Canada.
authors.forename: Naresh C
authors.initials: NC
authors.lastname: Sharma
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Lyle
authors.forename: Jimmy G
authors.initials: JG
authors.lastname: Qaqish
authors.forename: Jack
authors.initials: J
authors.lastname: Galustians
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schuller
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000209:etiology / Q000517:prevention & control*; D003774:Dental Plaque Index; D003777:Dental Prophylaxis / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D009967:Orthodontic Appliances / Q000009:adverse effects; D010512:Periodontal Index; D016037:Single-Blind Method; D014099:Toothbrushing; D014867:Water
chemical_list: D014867:Water