title: Treatment outcomes of dental flossing in twins: molecular analysis of the interproximal microflora.
abstract: BACKGROUND
  The purpose of this study was to assess the effects of dental flossing on the microbial composition of interproximal plaque samples in matched twins.
  
  
  METHODS
  The study was a two-treatment, examiner-masked, 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 tongue brushing and toothbrushing or tongue brushing and toothbrushing plus flossing. The reverse-capture checkerboard hybridization assay was used to assess levels (abundance) of 26 microbial species in interproximal plaque samples collected from six sites per subject. An integrative computational predictive model estimated average changes in microbial abundance patterns of selected bacterial species from baseline to 2 weeks by comparing treatment groups.
  
  
  RESULTS
  After the 2-week study period, putative periodontal pathogens and cariogenic bacteria were overabundant in the group that did not floss compared to the group that performed flossing. Those included Treponema denticola, Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), Prevotella intermedia, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Streptococcus mutans. Microbial species that are not consistent with the development of periodontal disease or dental caries were overabundant in the group that did floss compared to the non-flossing group.
  
  
  CONCLUSIONS
  In a well-matched twin cohort, tooth and tongue brushing plus flossing significantly decreased the abundance of microbial species associated with periodontal disease and dental caries after a 2-week program.
authors.affiliation: Department of Periodontics, New York University College of Dentistry, New York, NY 10010, USA. patricia.corby@nyu.edu
authors.forename: Patricia M A
authors.initials: PM
authors.lastname: Corby
authors.forename: Aaron
authors.initials: A
authors.lastname: Biesbrock
authors.forename: Robert
authors.initials: R
authors.lastname: Bartizek
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Corby
authors.forename: Robin
authors.initials: R
authors.lastname: Monteverde
authors.forename: Rafael
authors.initials: R
authors.lastname: Ceschin
authors.forename: Walter A
authors.initials: WA
authors.lastname: Bretz
mesh_terms: D000293:Adolescent; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000145:classification; D001419:Bacteria / Q000145:classification*; D001439:Bacteroides / Q000145:classification; D002648:Child; D015331:Cohort Studies; D015169:Colony Count, Microbial; D003731:Dental Caries / Q000382:microbiology; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000382:microbiology*; D005260:Female; D005881:Gingiva / Q000382:microbiology*; D006801:Humans; D008297:Male; D010510:Periodontal Diseases / Q000382:microbiology; D016966:Porphyromonas gingivalis / Q000145:classification; D018713:Prevotella intermedia / Q000145:classification; D013295:Streptococcus mutans / Q000145:classification; D014059:Tongue / Q000382:microbiology; D014099:Toothbrushing / Q000295:instrumentation / Q000379:methods; D014100:Toothpastes / Q000627:therapeutic use; D016896:Treatment Outcome; D048373:Treponema denticola / Q000145:classification; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic
chemical_list: D014100:Toothpastes