Comparative efficacy of water flosser and regular floss for plaque removal in patients with fixed dental prosthesis: A randomized controlled trial

Background This study aimed to evaluate the effectiveness of water flossers, regular dental floss, and manual toothbrushes in the removal of interdental plaque in fixed dental prosthesis users for over one month. Methods A parallel group randomized controlled trial was conducted in which 30 participants were randomized into three groups, with 10 in each group using a manual toothbrush, regular dental floss, and water flosser. Silness and Loe plaque index values were recorded at the first visit, after 1 week, and after 3 weeks. One-way ANOVA and post-hoc Tukey tests were used to compare the scores. Results One-way ANOVA showed significant differences in plaque scores between the three groups at both the first (p < 0.001) and second recall (p < 0.001). Post hoc tests revealed that the water flosser group showed a significant improvement in plaque removal compared to both the regular dental floss (mean difference = 0.17, p = 0.001) and manual toothbrush (mean difference = 0.242, p < 0.001) groups. Conclusion The water flosser demonstrated superior plaque removal efficacy in patients with a fixed dental prosthesis compared to other manual plaque control aids. Thus, they are the preferred cleaning aid for individuals with fixed dental prostheses, enabling enhanced oral hygiene maintenance. Trial Registration : Trial registered in CTRI (Clinical Trials Registry- India) registration number: CTRI/2024/07/071503.