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30 June 2020

Interdental cleaning : what kind of tool?

Giulia Palandrani

Daily removal of dental plaque is considered important for oral health maintenance and prevention of periodontal diseases and dental caries.

People routinely use toothbrushes at home to remove supragingival dental plaque, but toothbrushes are unable to penetrate the interdental area where periodontal diseases first develop. Besides toothbrushing different interdental aids to plaque removal, for example, dental floss or interdental brushes, are widely available and often recommended for use in addition to toothbrushing .

The objective of the review is to evaluate the effectiveness of interdental cleaning devices used at home, in addition to toothbrushing, compared with toothbrushing alone, for preventing and controlling periodontal diseases, caries, and plaque


This review included 35 randomised controlled trials (RCTs) with a total of 3929 participants. Toothbrushing was undertaken by all participants in all studies. The participants in 33 of the 35 studies used a manual toothbrush, two used powered toothbrush. The studies evaluated the use of floss, interdental brush, tooth cleaning stick - wooden or rubber, and oral irrigation to remove plaque from the teeth. 

Low-certainty evidence suggested that floss, in addition to the toothbrush, can reduce gingivitis and that interdental brushes can reduce plaque more than just toothbrush.

Interdental brushes seem to reduce gingivitis more than dental floss.

Very-low certainty evidence suggested that the use of an interdental brush, in addition to the toothbrush, as well as the use of oral irrigation can reduce gingivitis.

However, oral irrigation do not seem to reduce the amount of plaque more than just the brush.


Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis and/or plaque, more than toothbrushing alone. Interdental brushes may be more effective than floss. Available evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent. Overall, the evidence was low to very low-certainty, and the outcomes were mostly measured in the short term effect

For additional information: Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. 

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