Can the flusher remove dental plaque

In 1962, the first dental flusher was introduced into the dental industry. It was developed by a dentist in Colorado. To improve the patient's oral hygiene, he received the help of a hydraulic engineer. The Teeth flushing device is also called an oral irrigator. Although it is one of the most studied personal care devices on the market, there are still questions about its efficacy, safety, and results. This article will provide answers to many of these questions based on the results of clinical studies.

Can the flusher remove dental plaque (biofilm)?

A study in 1971 reported that the accumulation of plaque and the formation of calculus in the flushing group were significantly reduced, and the calculus in the flushing group was reduced by 50%. The reduction of dental plaque has also been demonstrated in studies of patients with gingivitis, periodontitis, orthodontic appliances, and diabetes.

In 2009, a team evaluated the removal of biofilm on the tooth surface with a dental flusher. In this in vitro study, periodontally diseased teeth were extracted and new biofilms were grown on existing deposits. Then the teeth were treated with a dental flusher under moderate pressure for 3 seconds. The result was observed under a scanning electron microscope and showed that 99.9% of the biofilm was removed from the treated area.

A recent study measured the removal of dental plaque after one-time use of dental floss and then evaluated the results after 4 weeks. When used in conjunction with a manual toothbrush, the flusher can remove 75% of the plaque of the whole mouth after one use. When isolating a specific area, the result is 84% of the face, 66% of the tongue, 59% of the marginal area, and 92% of the approximate area. The results of 4 weeks showed that the total mouth dental plaque was reduced by 51%, the specific area of the face was reduced by 53%, the tongue measurement was reduced by 49%, and the margin was reduced by 25%, which is an approximate reduction of 77%.

Will the flusher bring bacteria into the periodontal pocket?

Studies have shown that dental flushers do not push bacteria into the periodontal pocket; in fact, the situation is just the opposite. A teeth flusher can remove bacteria in the periodontal pocket. Several studies have shown that after using a flusher, the bacteria in the periodontal pocket will be reduced. An early study was conducted on subjects using fixed orthodontic appliances to measure the ability of flushing teeth to reduce bacteria. At the end of the 63-day study, the results of a group of patients using manual toothbrushes and flushing devices showed that this method was 80% more effective than brushing and gargle in reducing total aerobic flora, reducing total aerobic bacteria Group effective 60%.

The removal of bacteria is accomplished by the pulsating action of the device. This results in compression and decompression phases in the impact and flushing zone and allows bacteria and debris to be removed from the pockets. Compared with the untreated area, the number of microorganisms in the flusher group is reduced by up to 6 mm, which has thick microorganisms.

How is the performance of dental floss better than dental floss?Recommendations for dental floss may be more academic rather than based on research. This was exposed when a systematic review reported comparing the results of brushing alone with brushing and flossing. A meta-analysis of dental plaque and gum index showed no difference between the groups. The authors conclude that the study does not support the conventional recommendations for flossing. Coupled with poor compliance and poor technology, the patient's preference for alternatives and the need for alternatives are obvious. Regarding the question of whether dental floss can prevent interdental caries, it has been found that dental flossing can effectively reduce the risk of interproximal caries only when it is performed by dental professionals on children with low fluoride exposure. Teenage flossing on their own has shown no benefit, and there have been no studies conducted in adults or unsupervised.

How does the dental flusher work?

There are two basic types of flusher devices. The first is a mechanized device powered by a power socket or battery. It usually provides a pulsating water flow, but not all mechanized devices will pulsate. The pressure can be changed, and the pulsation is controlled by the motor. The other is a non-mechanized device, which is connected to a water source (such as a faucet or shower) and provides a constant flow of water. Devices on the market have different characteristics, designs, and most importantly, different combinations of pulsation and pressure.Early studies evaluated the safety and mechanism of action, especially the combination of pulsation and stress. According to reports, the combination of 1,200 to 1,400 pulsations per minute is a key component of effectiveness, as this produces compression and decompression phases. This hydrodynamic activity creates an impact and flushing zone that allows debris and bacteria to be expelled from the ditch or bag, which is reported to be three times more efficient than continuous-flow devices.

Who should use a water flosser?

Dental professionals' recommendations for self-care equipment are based on personal needs, values, preferences, and expected results. Studies have shown that dental flushers can benefit many patient types and oral conditions.

Orthodontics

Regardless of age, orthodontic appliances face oral hygiene challenges. A study of 105 adolescents between the ages of 11 and 17 using water flossers with orthodontic tips showed that dental plaque and bleeding were significantly reduced within 4 weeks. These results are similar to a previous study that paired a flusher with a manual or electric toothbrush and compared it with adult orthodontic patients brushing their teeth alone. Regardless of the toothbrush used, the group of subjects who used the flusher experienced a greater reduction in bleeding and inflammation compared with subjects who only brushed their teeth.

Periodontal care

Patients undergoing periodontal maintenance therapy are at increased risk of losing attachment in the future and require good oral hygiene. The patient may have to clean the concavity of the proximal surface of the tooth and may leave a dent of 4 mm to 6 mm to maintain it. Interdental equipment such as dental floss, toothpicks, and interdental brushes cannot clean these pockets and may not reach the recesses or forks.

Several studies have evaluated the subgingival penetration of oral irrigators. Standard nozzles placed at 90 degrees and 45 degrees between the gingival edge and the long axis of the teeth were tested. For these two angles, the penetration depth varies with the depth of the pocket, with an average of 50%. When the nozzle is placed at a 90-degree angle, the average of shallow pits (0 mm to 3 mm) is 71%, the average of medium pits (4 mm to 7 mm) is 44%, and the average of deep pits (>7 mm) An average of 67% mm obtains penetration. It is worth noting that 75% or more penetration was seen in 60% of pockets >7mm. The permeability of the 4 mm to 6 mm capsular bag is 42%, and the permeability of the 7 mm to 10 mm capsular bag is 39%. According to reports, a special nozzle placed under the gingival reduces the flow and pressure to 90% of 6mm bags and 67% of ≥7mm bags.

Implants

Implants need daily care like natural teeth. By comparing the irrigation with 0.12% chlorhexidine and the special subgingival nozzle with 0.06% chlorhexidine for irrigation, the dental flusher was tested on the implant. Researchers found that using a dental flusher to use diluted chlorhexidine is more effective than using 0.12% chlorhexidine to rinse: 29% and 9% of dental plaque, and 45% and 10% of gingivitis.

Diabetic

People with diabetes have an increased risk of periodontal disease, which may appear earlier and be more serious. Finding a way to control inflammation is important and may require a more focused or rigorous home care plan. In a 3-month clinical trial, the dental flusher proved to be beneficial to this population. Fifty-two patients with type 1 and type 2 diabetes were randomly assigned to one of the two groups. The first group used a flusher and manually brushed their teeth twice a day. People in the control group continued their current oral hygiene habits. At the end of 3 months, compared with the control group, the dental appliance group had a significant improvement in gingivitis, plaque, and bleeding during probing.

Some studies have shown that dental flushing devices are beneficial to patients with varying degrees of gingivitis. Other people who might benefit are those with an increased risk of infection or inflammation or even those with relatively better home care. Monitoring risks is important because conditions and medical history may change.

In conclusion

The study supports the recommendation and use of dental flushers for patients with different needs and concerns. Many studies can help practitioners make informed decisions, and they should discuss these issues with patients to help them improve their oral health. Clinicians should remind patients that it is never too early or too late to start a good oral hygiene program. Practitioners should not wait for problems to arise but should prescribe equipment and methods that patients like and use. Instructing young patients is especially helpful.