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Dental flossing and interproximal caries: a systematic review
P P Hujoel1, J Cunha-Cruz, D W Banting
1Department of Dental Public Health Sciences, University of Washington, Seattle, WA 98195, USA. hujoel@u.washington.edu
Journal of Dental Research
|March 29, 2006
Summary
Professional flossing significantly reduces interproximal caries in children. However, self-flossing and less frequent professional interventions showed no caries risk reduction, highlighting the importance of consistent, supervised oral hygiene practices.
Area of Science:
- Dental Public Health
- Preventive Dentistry
- Caries Research
Background:
- Interproximal caries (cavities between teeth) pose a significant risk to children's dental health.
- The effectiveness of flossing as a preventive measure against interproximal caries requires systematic evaluation.
Purpose of the Study:
- To systematically assess the impact of dental flossing on the risk of developing interproximal caries.
- To analyze different flossing protocols, including professional versus self-performed and varying frequencies and durations.
Main Methods:
- A systematic review of six randomized controlled trials involving 808 children aged 4-13 years.
- Analysis of studies with potential for moderate to large bias, focusing on professional school-based flossing and self-performed flossing.
Main Results:
- Professional flossing, conducted daily for 1.7 years in schools, reduced caries risk by 40% in children with low fluoride exposure (RR 0.60).
- Three-monthly professional flossing for 3 years and self-performed flossing in adolescents for 2 years did not demonstrate a significant reduction in caries risk (RR 0.93 and 1.01, respectively).
- No studies were identified for adults or unsupervised flossing conditions.
Conclusions:
- Daily professional flossing in a school setting is highly effective in reducing interproximal caries risk in children, particularly those with limited fluoride exposure.
- The benefits of flossing may be dependent on the method, frequency, supervision, and patient population, as self-performed flossing showed no effect.
- Findings suggest that consistent, professionally administered flossing can be a valuable tool in pediatric caries prevention, but results may not directly translate to typical self-care practices.
