Oral Irrigation

Husseini, A., Slot, D., & Weijden, G. V. (2008). The efficacy of oral irrigation in addition to a toothbrush on plaque and the clinical parameters of periodontal inflammation: A systematic review. International Journal of Dental Hygiene,6(4), 304-314.

This article discusses the effective of oral irrigation as a means of plaque control. It states that toothbrushing is the most common type of plaque removal and daily interproximal plaque control is not common behavior. Patient motivation and dexterity remains the two most common barriers to compliance in interproximal cleaning. Auxiliary aids such as the oral irrigator or water flosser have been developed to make it easier for patients to adhere to a regular flossing routine. Various studies on oral irrigation have provided mixed results on its efficacy as both positive and negative results have been reported. This article is a systematic review of a number of studies chosen based on their quality. All studies compared the effects of toothbrushing and oral irrigation compared to toothbrushing alone (control group). In a handful of studies, results showed an improvement after the introduction of oral irrigation as well as a reduction in bleeding. Pertaining to plaque, the review found that across the board no study showed a significant difference between the toothbrush plus water flosser groups and the groups that used toothbrushing alone. There are varying opinions from clinicians on the effectiveness of adjunctive oral irrigation therapy, and the selected studies reviewed did no provide sufficient data to provide a meta-analysis. To summarize the findings, the selected studies did not provide sufficient evidence that oral irrigation provided any additional benefit for plaque control to toothbrushing alone, but an improvement in overall gingival health was suggested by the results. This article affects me as a dental hygiene student because it is my job to provide the patient with adequate oral hygiene instruction and to suggest various auxiliary aids to increase

compliance with home care. It is important to know which aid is appropriate for each condition or problem presented. According to this article, oral irrigation does not necessarily reduce the presence of plaque compared to toothbrushing alone, but it may be valuable in the reduction of gingival bleeding and improvement of periodontal health. I will probably not use information from this article in the future as a hygienist, because the results overall seemed inconclusive. There is considerable evidence that water flossers are effective as adjunctive therapy, and I would never discourage a patient from using an auxiliary aid if it gets them to comply with interproximal cleaning. Information in the article that relates to something I have learned in a previous dental hygiene course include that oral irrigation can reduce gingival bleeding and bacteremia which overall has the potential to improve gingival health overall. I found that a lot of the information presented contradicted itself and was lacking in certain ways. The authors claimed almost definitively that oral irrigation had little effects on plaque removal, but the studies reviewed had mixed results. The authors only reviewed seven total studies. In order obtain enough data to form a conclusion more studies should have been included. Additionally, there was very little information on whether or not patients were using the aids correctly in order to maximize its benefits or whether or not the toothbrushing was adequate, which I believe can be highly variable.