Discussion
long-term disturbance, bleeding, inflammation, periodontitis, gingivitis, Gingivitis, agitation
BLEEDING, SUPRAGINGIVAL DENTAL PLAQUE, INFLAMMATION, DISEASE, PERIODONTITIS, DENTAL PLAQUE, GINGIVITIS, GINGIVITIS, PLAQUE, DISEASES
Gingivitis is a typical plaque-related oral diseases, and plaque control has been proved to be an effective way to prevent and treat this disease. Accumulating evidence has demonstrated that water flossing can ameliorate gingival inflammation by removing dental plaque [Water flossing promotes gingival health by facilitating removal of dental plaque. Here, we found that both water-flossing and toothbrushing groups exhibited ameliorated gingival inflammation as reflected by gingival index, sulcus bleeding index, and BOP%. More importantly, the gingival and sulcus bleeding indices in the water-flossing group were lower than those in toothbrushing control at 8 and 12 weeks, indicating that adjunctive application of water flossing to toothbrushing can better promote periodontal health. Consistently, several randomized controlled trials found that the addition of a water flosser to toothbrush could significantly reduce the BOP, gingival index, and plaque index at 4-week compared with the toothbrush alone [As water flossing is a well-recognized oral hygiene technique via active agitation and removal of supragingival dental plaque, whether its daily use may pose long-term disturbance on oral microecology is worth clinical validation. Here, we observed an altered microbial structure and composition after 12-week use of the respective oral hygiene regimens. More importantly, we also observed that periodontal anaerobes, such as In addition to gingival inflammation, oral malodor, which is mainly derived from the metabolic production of volatile sulfur compounds (VSCs) by periodontal anaerobes, is usually accompanied with periodontal conditions such as periodontitis and gingivitis [In conclusion, the current study demonstrates that water flossing can effectively alleviate gingival inflammation and reduce oral malodor, possibly by depleting oral anaerobes and altering the oral microbiota to a more aerobic phenotype.