Effects of a mechanical interdental cleaning device on oral hygiene in patients with lingual brackets

This study was aimed at determining the influence of a battery-operated interdental cleaning device (icd) (WaterPik Flosser) on the oral hygiene of 32 female right-handed patients (mean age 25.9 years) with lingual brackets in the upper (n = 29) and or in the lower arch (n = 25). Approximal plaque index (API) and bleeding on probing (BOP) were recorded at the lingual surfaces by a single blinded examiner before application (t0), on average 38.6 days after (t1), and again on average 46.0 days after (t2) the application of the icd. The patients used the icd once a day in the second and fourth quadrants only (icdq). In all quadrants (icdq and non-icd quadrants [n-icdq]), oral hygiene was performed with a manual toothbrush. Of the patients enrolled in the study, 96.9% found the icd subjectively very helpful to moderately helpful for cleaning their teeth and 65.6% had the subjective impression that their teeth were cleaner with the appliance. Despite those positive subjective assessments, an objective comparison of the icdqs with the n-icdqs revealed no statistically significant differences in the mean changes in API and BOP from t0 to t1, from t0 to t2, or from t1 to t2. Because there were spectacular improvements in API in all quadrants, the improvements could be interpreted as an outcome of the instruction and motivation given to the patients, the increasing awareness of oral hygiene, and the greater skill in using the toothbrush in the course of time.