title: Prebrushing rinse with water on plaque removal: a split-mouth design.
abstract: OBJECTIVE
  The aim was to evaluate whether there is an additional beneficial effect on dental plaque removal of rinsing the oral cavity with water before toothbrushing.
  
  
  METHODS
  In total, 48 non-dental, systemically healthy participants ≥18 years were included in this randomized controlled clinical trial using a split-mouth design. The participants were requested to refrain from any form of oral hygiene for 48 h. First dental plaque scores (PI) were assessed full mouth. Two randomly assigned contra-lateral quadrants were brushed. Next the participant rinsed for 1 min with 15 ml water. Subsequently, the opposite two contra-lateral quadrants were brushed. Brushing was performed without toothpaste. Subsequently the second full-mouth PI assessment was performed. The brushing and rinsing procedure was performed under supervision and brushing time was tracked by a timer, each quadrant was brushed for 30 s. For the buccal, lingual, and approximal surfaces and tooth type, a subanalysis was performed.
  
  
  RESULTS
  At baseline there was no statistically significantly difference between the two sets of contra-lateral quadrants. When a water rinse was used before toothbrushing the PI-score was reduced by 58%. If water rinse was used post-brushing the PI-score reduced by 57%. The difference of 0.04 in mean plaque index score reduction between the two brushing regimens was not significant(P = 0.162).
  
  
  CONCLUSIONS
  When a 2 min brushing exercise was performed, on average more than 55% dental plaque was removed. Prerinsing with water did not contribute significantly to toothbrush efficacy.
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Van der Sluijs
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: D E
authors.initials: DE
authors.lastname: Slot
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: N L
authors.identifier: http://orcid.org/0000-0002-6740-5657
authors.initials: NL
authors.lastname: Hennequin-Hoenderdos
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: Mpc
authors.initials: M
authors.lastname: Van Leeuwen
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: G A
authors.initials: GA
authors.lastname: Van der Weijden
mesh_terms: D000328:Adult; D003773:Dental Plaque / Q000517:prevention & control*; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D008297:Male; D014099:Toothbrushing; D016896:Treatment Outcome; D014867:Water / Q000008:administration & dosage*
chemical_list: D014867:Water
keywords: plaque; post-brushing rinse; prebrushing rinse; water