ArticleClinical oral investigations2025
Does proper flossing performance translate into effective plaque removal?
Article in Clinical oral investigations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Digitally-driven optimization of intraoral water jet parameters for plaque removal: a personalized 3D-guided orthogonal study.BMC oral health · 2026Article
- Reliability and Diagnostic Performance of Digital Versus Clinical Assessment of Oral Hygiene and Gingival Health in Older Community-dwelling Adults.Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric DentistryObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesInterdental hygiene plays a crucial role in maintaining oral health, yet the effectiveness of dental floss remains a subject of debate. Thus, this study aimed to assess whether improved flossing technique relates to improved cleaning efficacy. MATERIALS AND
methodsA total of 37 adults (23.1 ± 3.2 years) participated. After habitual toothbrushing, plaque was disclosed and an intraoral scan was performed; afterwards, habitual flossing was videotaped, followed by a second intraoral scan of disclosed plaque. Participants then watched an instruction video. After one week of practice, flossing was again videotaped and intraoral scans were taken before and after flossing. On defined regions on images obtained from the four scans, plaque coverage was assessed with a three-level score (0: none, 1: <50%, 3: ≥50%). Proximal Surface Plaque Index (PSPI) was calculated as mean from all scores. A flossing performance score (FPS) was generated from the percentage of interdental spaces that were correctly flossed (interdental space reached, floss correctly applied and vertical movements; 0: totally imperfect, 3: perfect flossing). Ramfjord teeth (16, 21, 24, 36, 41, 44) were analysed, values are given as median [95% CI].
resultsFPS improved distinctly after instruction (2.0 [1.48;2.54] vs. 2.83 [2.45;2.95]; (p < .001), but not plaque removal (difference PSPI before/after: 0.17 [0.04;0.25] vs. 0.21 [0.13;0.25]; p = .112). Plaque removal was not correlated with PSPI.
conclusionThese findings suggest that even with correct technique, flossing may not substantially reduce plaque levels. CLINICAL RELEVANCE: The results align with previous studies questioning the efficacy of flossing and highlight the need for further investigation into interdental cleaning approaches.
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