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Safety of a Water Flosser: A Literature Review
Jolkovsky DL, Lyle DM. Compendium of Continuing Education in Dentistry 2015; 36(2):2-5.
Objective: Since the introduction of the first Waterpik® Water Flosser in 1962, over 60 clinical trials have been published. Collectively, the studies demonstrate significant plaque removal, reduction of gingival bleeding, and reversal of inflammation (gingivitis). The majority of the studies are randomized controlled trials and published in peer-reviewed journals providing the reader with the best evidence to make informed clinical decisions. This literature review was designed specifically to address the safety of a Water Flosser.
Methodology: This review was divided into four sections: histological findings, subgingival pathogens, probing pocket depth and clinical attachment levels, and bacteremia.
Results: Histological findings: Studies showed a significant reduction in inflammation on the cellular level compared to non-treated sites which showed varying levels of inflammation. This confirms that a Water Flosser is safe for the periodontal pocket tissue.
Subgingival pathogens: Studies show significant removal of subgingival pathogens, even in deep pockets, with the use of a Water Flosser. This was not generally seen in non-Water Flossed sites. This addresses the concern that bacteria might be driven deeper into pockets.
Pocket depths and clinical attachment levels: Studies show a significant improvement in probing pocket depth and clinical attachment levels or no change. These studies address the concern that a Water Flosser might break the epithelial attachment.
Bacteremia: Research shows the incidence of bacteremia is the same for tooth brushing, flossing, wood sticks, water flossing and mastication.
Conclusion: This evidence addresses potential safety concerns associated with water flossing. It is important to make clinical decisions on the best evidence available versus anecdotal information or assumptions. This will help dental professionals provide the best recommendations for their patients that ultimately provide the best oral health outcomes.
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