Efficacy of Brush, Floss, Rinse Regimens vs. Mechanical Oral Hygiene

OBJECTIVES: The purpose of this study was to compare the plaque and gingivitis reduction of two brush, floss and antimicrobial rinse regimens to the mechanical oral hygiene regimen of brushing alone.

METHODS: This was a 3-month, randomized, controlled, observer-blind, parallel group clinical study.  191 healthy adults with mild to moderate gingivitis Modified Gingival Index (MGI) ≥ 1.75 and modification of the Turesky modification of the Quigley Hein Plaque Index (PI) ≥ 1.95 were randomized into 3 treatment groups:   BFEO- brush [REACH^® ULTRACLEAN^®], floss[REACH^® ULTRACLEAN^®] and EO rinse [LISTERINE^® Antiseptic], BFCPC – brush[Oral-B^® CrossAction^® Pro-Health^®] floss[Glide^® Deep Clean] and CPC rinse[Crest^® Pro-Health™] or B- brushing alone [Oral-B^® Indicator^®].  All subjects received oral and written home care instructions.  To maximize compliance, flossing subjects received a flossing demonstration and had to demonstrate correct flossing technique at various timepoints during the study.  All subjects were monitored for compliance with their assigned regimen.  Examinations for MGI and PI were conducted at Baseline, 6 and 12 weeks. 

RESULTS: All 191 subjects completed the study.  After 6 weeks the BFEO group resulted in a 21.3% reduction and the BFCPC group in a 12.7% reduction in whole mouth MGI vs. the B group(p<0.001) and 29% reduction and a 20.7% reduction vs. B after 12 weeks(p<0.001).  Similar trends were observed for plaque.   After 6 weeks, the BFEO group resulted in a 48.9% reduction and the BFCPC group in a 34.1% reduction in whole mouth PI vs. the B group (p<0.001) and 64.8% reduction and a 56.4% reduction vs. B after 12 weeks (p<0.001)

CONCLUSIONS: These results demonstrated that a 3-step regimen consisting of daily flossing, brushing and rinsing with an EO mouthrinse provides greater clinical efficacy in reducing gingivitis and plaque compared to a regimen with a CPC containing mouthrinse as well as brushing alone.