Flossing: Before or after brushing?


This review comparing the clinical performance of flossing before or after toothbrushing included two small RCTs involving a total of 60 patients. The findings suggest no difference with the use of floss before or after toothbrushing however the quality of the evidence is limited.

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Rubber bristles interdental cleaners as an adjunct to toothbrushing


This review of the efficacy of rubber bristles interdental cleaners (RBIC) as an adjunct to toothbrushing (TB) included 6 RCTs. The findings provide weak to very weak certainty evidence for the use of RBICs for gingivitis and plaque reduction.

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Top Dental Elf Blogs Apr– Jun 2019

The Dental Elf brings you daily updates of evidence-based dentistry research

The Cochrane review of interdental cleaning devices, whether antibiotics are needed for dental implant placement and oral health programmes for people with intellectual difficulties were our most popular blogs of the spring.

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Interdental cleaning devices for prevention and control of caries and periodontal disease


Thi Cochrane review evaluateingthe effectiveness of interdental cleaning devices used at home, in addition to toothbrushing, compared with toothbrushing alone, for preventing and controlling periodontal diseases, caries, and plaque includes 35 RCTs providing low to very low certainty evidence that floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque, or both.

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Interdental cleaning aids


This network meta-analysis of the comparative efficacy of interproximal oral hygiene aids included 22 RCTs and suggests that interdental brushes and water-jets ranked highest for the reduction of gingival bleeding. Although the quality of the available evidence is limited.

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Periodontitis: risk increased by poor oral hygiene


50 observational studies were included in this review of the effect of oral hygiene on periodontitis. The data suggests that poor oral hygiene increases the risk of periodontitis by around two- to five-fold compared with good OH. However the quality of the data is considered to be of low quality.

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Which interdental cleaning aids for managing gingivitis?


A number of reviews have been conducted of interdental cleaning aids. This meta-review brings together 6 reviews and finds only evidence of low quality for interdental brushes, floss, woodsticks and oral irrigators.

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Flossing, scaling and bugs in the blood

shutterstock_14313976- bacteria

Some of the evidence used to in the formulation of the NICE guidance on antibiotic prophylaxis for invasive dental procedures that we discussed yesterday was the recognition that everyday oral activities cause bacteraemia (Dental Elf  10th May 2011). This new cross-sectional study by Zhang et al looked the bacteraemia caused by flossing compared with scaling [read the full story…]

People who brush and floss regularly have less gum bleeding compared to toothbrushing alone

Logo of The Cochrane Collaboration

The daily use of dental floss in addition to toothbrushing is frequently recommended for the prevention of caries and periodontal diseases. The aim of this Cochrane review was to assess the effects of flossing in addition to toothbrushing, as compared with toothbrushing alone, in the management of periodontal diseases and dental caries in adults. A [read the full story…]

Bacteraemia due to everyday oral activities

shutterstock_26227375 toothbrushes and toothpaste

The aim of this review was to investigate the robustness of the observations on the influence of oral hygiene, gingival and periodontal status on the development of bacteraemia from everyday oral activities (B-EOA), analysing its prevalence, duration, magnitude and bacterial diversity. The authors searched MEDLINE-PubMed, the Cochrane Library and Embase for studies on B-EOA. They [read the full story…]