Interdental Cleaning Aids are Beneficial for Oral Health at Follow-up

Objectives: We estimated associations of interdental cleaning aids (IDA) use and type on follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study.
Methods: We used 7-year follow-up data of 2,224 participants of the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation.
Results: Participants were followed for an average of 7.4 years. Flossers were 40% and 30% less likely to have higher interdental plaque and bleeding on probing than IDA non-users, respectively. Flossing was associated with lower follow-up levels of mean interdental probing depths (Odds Ratio (OR)=0.63;95% confidence interval (CI):0.45-0.87) and mean interdental clinical attachment levels (OR=0.69;95%CI:0.50-0.96). Interdental brushing was associated with lower follow-up levels for interdental plaque (OR=0.68;95%CI:0.53-0.86), interdental bleeding on probing (OR=0.62;95%CI:0.48-0.81) and mean interdental probing depths (OR=0.72;95%CI:0.54-0.97). The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (IRR=0.70) compared to IDA non-users.
Conclusions: Recommending flossing and interdental brushing in dental practices could represent an approach to the prevention of gingivitis and consequently periodontitis.