Interdental brush or oral irrigator?

PD Dr. Kristina Bertl, PhD MSc MBA

In periodontal maintenance therapy, keeping our patients motivated is particularly important – in terms of both oral hygiene and attending appointments at the dental practice (see also: Is compliance possible? Yes, if patients are informed and motivated! However, life-long oral hygiene measures in particular are often an obstacle. Accordingly, this gives rise to the valid question of whether, in relation to successfully treated periodontitis patients, the choice of oral hygiene product has an effect on the risk of periodontal disease re-occurring.

A Brazilian research group posed this question and conducted a six-year prospective cohort study involving 142 patients (Costa et al. 2020). The cohort was divided into three groups according to the oral hygiene products they used:

The results from six years after the start of maintenance therapy regarding the recurrence of periodontal disease clearly supported the use of an additional oral health product (i.e. the second and third groups). The following rates of recurrence of periodontal disease after six years were determined for the three groups:

In short, the rate of recurrence of periodontal disease was significantly higher in the group that only used a manual toothbrush and dental floss than in the other two groups. This in turn means that we should be constantly encouraging our patients to use more than just a manual toothbrush and maybe dental floss.

Other factors that represented an increased risk for the recurrence of periodontal disease were:
Age > 50 years, smoking, and bleeding on probing in > 30% of sites.

In this population, the oral irrigator even showed slight advantages over the interdental brush. However, this comparison certainly needs to be investigated further, and it probably also depends on the severity of the included population’s interdental attachment loss.

Reference

1. Costa FO, Costa AA, Cota LOM. The use of interdental brushes or oral irrigators as adjuvants to conventional oral hygiene associated with recurrence of periodontitis in periodontal maintenance therapy: A 6-year prospective study. J Periodontol. 2020;91:26–36. https://doi.org/ 10.1002/JPER.18-0637