Efficacy of Green Tea Extract–Impregnated Dental Floss Compared to Chlorhexidine and Conventional Floss in Reducing Supragingival Plaque and Gingival Bleeding: A Randomized Controlled Trial

OBJECTIVE: To evaluate and compare the efficacy of 5% green tea extract-impregnated dental floss and 5% Chlorhexidine gluconate-impregnated dental floss in reducing supragingival plaque and gingival bleeding. METHODS: A double-blind, parallel-arm randomized controlled trial was conducted among 60 healthy adults (20-25 years). Participants were randomly assigned to four groups (n = 15 each): 5% Green tea extract-impregnated dental floss (GTE-DF), 5% Chlorhexidine gluconate-impregnated dental floss (CHX-DF), waxed dental floss (W-DF) and toothbrushing only (TB). Following baseline supragingival scaling, participants were instructed to use the assigned oral hygiene regimen twice daily for 15 days. Clinical assessments were performed at baseline, 7 and 15 days using the Turesky Modified Quigley-Hein Plaque Index and Modified Sulcular Bleeding Index. Non-parametric analyses were performed using the Kruskal-Wallis and Friedman tests with post hoc analysis comparisons. Statistical significance was set at p < 0.05. RESULTS: Significant intergroup differences were observed for both plaque accumulation and gingival bleeding at 7- and 15-day follow-up (p = 0.001). At day 15, the CHX-DF group demonstrated the lowest mean plaque score (0.75 ± 0.08), followed by GTE-DF (0.86 ± 0.11) and W-DF (1.06 ± 0.09). Plaque reduction was comparable between CHX-DF and GTE-DF (p > 0.05). Gingival bleeding was significantly lower in the CHX-DF group compared to all other groups at both follow-ups (p ≤ 0.014). GTE-DF also demonstrated significantly greater reductions in gingival bleeding than W-DF and TB groups (p ≤ 0.008). CONCLUSION: Both CHX-DF and GTE-DF effectively reduced supragingival plaque and gingival inflammation compared with conventional flossing and toothbrushing alone. Although GTE-DF demonstrated antiplaque efficacy comparable to CHX-DF, CHX-DF showed superior anti-inflammatory efficacy in reducing gingival bleeding. TRIAL REGISTRATION: Clinical Trial Registry of India registration number: CTRI/2023/09/057159.