Prebrushing rinse with water on plaque removal: a split-mouth design

The aim was to evaluate whether there is an additional beneficial effect on dental plaque removal of rinsing the oral cavity with water before toothbrushing.

In total, 48 non-dental, systemically healthy participants ≥18 years were included in this randomized controlled clinical trial using a split-mouth design. The participants were requested to refrain from any form of oral hygiene for 48 h. First dental plaque scores (PI) were assessed full mouth. Two randomly assigned contra-lateral quadrants were brushed. Next the participant rinsed for 1 min with 15 ml water. Subsequently, the opposite two contra-lateral quadrants were brushed. Brushing was performed without toothpaste. Subsequently the second full-mouth PI assessment was performed. The brushing and rinsing procedure was performed under supervision and brushing time was tracked by a timer, each quadrant was brushed for 30 s. For the buccal, lingual, and approximal surfaces and tooth type, a subanalysis was performed.

At baseline there was no statistically significantly difference between the two sets of contra-lateral quadrants. When a water rinse was used before toothbrushing the PI-score was reduced by 58%. If water rinse was used post-brushing the PI-score reduced by 57%. The difference of 0.04 in mean plaque index score reduction between the two brushing regimens was not significant(P = 0.162).

When a 2 min brushing exercise was performed, on average more than 55% dental plaque was removed. Prerinsing with water did not contribute significantly to toothbrush efficacy.