Does professional preventive care benefit from additional subgingival irrigation?

The effect of an oral irrigator (Water Pik, Intersante) with a subgingival tip (Pik Pocket Subgingival Tip, Intersante) in the reduction of gingivitis was investigated in a single-blind three-group study involving 45 volunteers (age 46.2+/-10.2). All volunteers (inclusion criteria: gingivitis or a superficial periodontitis) were examined and underwent professional tooth cleaning at the first appointment. They were then randomly distributed in three groups: one group used the irrigator with the subgingival tip once daily with just tap water, in addition to their regular oral hygiene; another group also used an herbal-based mouth rinse (Parodontax, GlaxoSmithkline) in the water of the irrigator; a third group did not use an irrigator or any irrigant and therefore served as control. All groups received professional oral care education at each appointment. The investigation period was 3 months. At baseline and after 4, 8, and 12 weeks, the plaque index (PI, scores 0-5), gingival index (GI, scores 0-3), bleeding index (BI scores 0-5), and sulcus fluid flow rate (SFFR, Periotron 6000) at the Ramfjord teeth were scored. At baseline and after 3 months, the probing depth (millimeters) was measured at six surfaces of all teeth. A significant reduction in BI, PI, GI, probing depth, and SFFR was observed within 3 months. With all volunteers, however, there was no statistically significant difference ( p>/=0.05, Wilcoxon-test, SAS 6.04) between the three groups at any time. The additional use of the Water Pik irrigator with the Pik Pocket subgingival irrigation device with or without an herbal mouth rinse showed no clinical benefit over professional education in oral hygiene alone.