Effect of Fluoridated Toothpicks and Dental Flosses on Enamel, Dentin, and Plaque Composition

Objectives: The aim was to evaluate the effect of various toothpicks and dental flosses on demineralized enamel and dentine and plaque composition, using an in situ model with simulated approximal spaces within dentures. Methods: 14 subjects with full dentures were included. The following 4 products were tested: 1) a birch toothpick with AmF, 2) a birch toothpick with NaF, 3) a dental floss with a mixture of AmF and NaF, and 4) a dental floss without F. A control period without any approximal cleaning was also carried out. Enamel and dentine specimens were demineralized to a subsurface lesion depth of around 100 µm. In small, rectangular sample holders, one enamel and one dentine specimen were embedded forming a triangular, approximal-like space. Two sample holders were mounted in each patient in the premolar-molar region of the upper or lower dentures. The subjects used the toothpick or dental floss 3 times/day for 4 weeks. After the 4-week periods, a plaque sample was collected for microbiological analyses, after which the enamel and dentine specimens were analysed by transversal microradiography (TMR). Results: All products inhibited further demineralization compared to the control period (p<0.001); the dental flosses seemed to be more effective in this respect than the toothpicks. There were small differences between AmF and NaF, but in favour for NaF regarding mineral gain (p<0.05). The fluoridated floss gave somewhat less lesion depth in dentine than the non-fluoridated floss (p<0.01). All products resulted in lower total counts and number of mutans streptococci in plaque compared to the control period (p<0.001). Conclusions: This study showed that a 4-week period with daily use of toothpicks and dental flosses has positive effects on enamel, dentine and plaque composition.