Bacterial colonization of a power‐driven water flosser during regular use. A proof‐of‐principle study

Bertl, Kristina; Johansson, Pia Edlund; Bruckmann, Corinna; Leonhard, Matthias; Davies, Julia R.; Stavropoulos, Andreas

doi:10.1002/cre2.393

Cited by 4 publications

(1 citation statement)

References 18 publications

(21 reference statements)

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“…In general, all studies included herein reported that PDICTs are indeed safe to use. Nevertheless, recent reports from our group have indicated that liquid‐based PDICTs are unavoidably colonized by oral bacteria, which can be transmitted via the water jet (Bertl, Edlund Johansson, Bruckmann et al, 2021 ; Bertl et al, 2022 ). Contamination of a specific liquid‐based PDICT with Streptococcus mutans was found in >95% of the samples, while periodontal pathogens were detected in 19%–56% of the samples (Bertl et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of power‐driven interdental cleaning tools: A systematic review and meta‐analysis

Edlund

Bertl

Pandis

et al. 2022

Clinical & Exp Dental Res

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Objectives: To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone or tooth brushing combined with any other non-PDICT in terms of interproximal plaque and gingival bleeding reduction in gingivitis patients. Material and Methods: A systematic literature search was performed in three databases until March 20, 2022 with the following main eligibility criteria: (1) randomized controlled clinical trials (RCTs) with (2) at least 28 days of follow-up in (3) gingivitis patients. Interproximal plaque and bleeding values were defined as the primary outcome variables and used for pair-wise meta-analyses. Results: Sixteen RCTs were identified including data from 1258 participants at the final evaluation. Eight studies each investigated the effect of either a liquid-based or mechanical PDICT; one of these studies tested additionally a combined liquid-based and mechanical PDICT. Tooth brushing combined with a liquid-based PDICT compared to tooth brushing alone did not result in better interproximal plaque values but in significantly lower interproximal bleeding values. Tooth brushing combined with either a liquid-based PDICT or with a mechanical PDICT compared to tooth brushing and flossing achieved comparable interproximal plaque and bleeding values. The majority of studies reporting on patient compliance/preference favored the use of a PDICT, and except for a single study, which was reporting soft tissue trauma in two subjects from improper use of a mechanical PDICT, none of the studies reported adverse events.Conclusions: Daily use of PDICT as an adjunct to tooth brushing significantly reduces interproximal bleeding.

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Section: Discussionmentioning

confidence: 99%

Efficacy of power‐driven interdental cleaning tools: A systematic review and meta‐analysis

Edlund

Bertl

Pandis

et al. 2022

Clinical & Exp Dental Res

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Patients' opinion on the use of 2 generations of power‐driven water flossers and their impact on gingival inflammation

Bertl

Johansson

Stavropoulos

2021

Clinical & Exp Dental Res

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Objectives: To assess patients' opinion on the use of 2 generations of power-driven water flossers and their impact on gingival inflammation. Material & Methods:In the present prospective cohort study 24 periodontitis patients under regular supportive periodontal therapy used daily 2 generations of a powerdriven water flosser (Sonicare AirFloss [SAF] and Sonicare AirFloss Ultra [SAFU]) for 12 weeks each. Patients were instructed to position the nozzle interproximally from the buccal aspect at each interproximal space. Patients' opinion was assessed by a questionnaire and interproximal bleeding on probing (BoP) was recorded.Results: Overall satisfaction with SAF/SAFU was rated high, by about 80% of the patients. About 66% of the patients preferred SAF/SAFU compared to their previous interdental cleaning device and indicated that they would continue using SAF/SAFU after the study; none of the patients reported any discomfort or pain. Compared to only tooth brushing, daily use of SAF/SAFU caused a significant reduction of interproximal BoP values, which were well maintained over 6 months; that is, BoP at interproximal buccal and oral sites (pooled), as well as at interproximal buccal and oral sites separately, was proportionately reduced by 29.1%, 41.2%, and 24.8%, respectively (pooled: p = 0.027; buccal sites: p = 0.030; oral sites: p = 0.030). Conclusion:Patients were very fond of the power-driven water flossers tested herein, and daily use of the devices for 6 months (i.e., each device was used for 3 months) resulted in a significant reduction of gingival inflammation interproximally.

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Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?

et al. 2021

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Objective To assess whether bacterial colonisation in a power-driven water flosser can be prevented. Materials and methods Twenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp. Results Contamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19–56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans. Conclusion Neither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU. Clinical relevance Bacterial colonisation in a power-driven water flosser seems impossible to prevent; to restrict the risk of cross-contamination within a household, one device per person should be recommended.

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Bacterial colonization of a power‐driven water flosser during regular use. A proof‐of‐principle study

Cited by 4 publications

References 18 publications

Efficacy of power‐driven interdental cleaning tools: A systematic review and meta‐analysis

Efficacy of power‐driven interdental cleaning tools: A systematic review and meta‐analysis

Patients' opinion on the use of 2 generations of power‐driven water flossers and their impact on gingival inflammation

Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?

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