Dental water jet and oral well being upkeep in orthodontic sufferers


The dental water jet or water flosser has been accessible because the Sixties, it produces a pulsating stream of pressurised water to take away plaque and particles from between the enamel and is used as an adjunct to toothbrushing to enhance oral well being. Research have demonstrated helpful results of gingival well being in some teams of sufferers with some research suggesting benefits for sustaining oral hygiene round orthodontic home equipment.

The intention of this assessment was to evaluate the impact of incorporating the dental water jet (DWJ) into the oral hygiene routines of orthodontic sufferers.


Searches have been carried out within the Cochrane Library, PubMed, Scopus and Internet of science databases. Randomised managed trials (RCTs) in sufferers present process mounted equipment therapy that in contrast guide tooth brushing (MTB) in opposition to MTB with adjunctive DWJ have been thought-about. Two reviewers independently chosen research and extracted information with examine high quality being assessed with the Cochrane danger of bias software (RoB2). The primary outcomes, Plaque index, Gingival index and Bleeding index have been reported as imply distinction (MD) with 95% confidence intervals (CI).


  • 6 RCTs (4 parallel, 1 cut up mouth, 1 cross-over) involving a complete of 313 sufferers have been included.
  • Solely 172 sufferers have been included in examine arms 85 obtained MTB and 87 obtained MTB+DWJ.
  • 2 research have been assessed as being at low danger of bias, 2 at average danger and a couple of at excessive danger.
  • 4 research contributed to the meta-analysis discovering a major enchancment in plaque index and bleeding scores within the DWJ + MTB group in contrast MTB alone. There was no distinction between the teams for the gingival index (see desk under).
  No. of research Imply distinction (95percentCI)
Plaque Index 4 −0.75 (−1.29 to −0.22)
Gingival index 4 −0.02 (−0.15 to 0.10)
Bleeding rating 3 −0.17 (−0.27 to −0.08)


The authors concluded: –

Using DWJ as an adjunctive gadget along with MTB could be an efficient technique for sustaining oral hygiene in orthodontic sufferers with gingivitis. Nonetheless, extra high-quality RCTs are wanted to substantiate the findings.


This assessment was not registered so no protocol was registered. Curiously there are at present 3  ongoing opinions of water flossers listed on the PROSPERO database considered one of which addresses the identical subject as this assessment (PROSPERO 395736). The reviewers searched 4 main databases lastly together with simply 6 RCTs with solely 4 contributing to the meta-analysis. The research are comparatively small with just one together with greater than 100 sufferers. The authors spotlight that solely 172 sufferers in whole obtained the comparability interventions. The follow-up durations are of quick period starting from 0ne to 6 months with just one examine of six months period.  The reviewers thought-about that 2 research have been at low total danger of bias though not one of the included research was at low danger in all domains thought-about. Solely 4 of the six research contributed the meta-analysis with the findings indicating vital enhancements in plaque index and bleeding scores however not the gingival index. Whereas a profit to oral well being is recommended from the adjunctive use of the DWJ the findings ought to be interpreted very cautiously due to the small variety of sufferers included in a small variety of research none of that are at low danger of bias. Future research ought to be effectively -conducted and reported and of acceptable dimension and period utilizing worldwide tips (Equator Community).


Main Paper  

AlMoharib HS, AlAskar MH, AlShabib AN, Almadhoon HW, AlMohareb TS. The effectiveness of dental water jet in decreasing dental plaque and gingival bleeding in orthodontic sufferers: A scientific assessment and meta-analysis of randomized medical trials. Int J Dent Hyg. 2023 Sep 11. doi: 10.1111/idh.12741. Epub forward of print. PMID: 37694518.

Different references

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Dental Elf – 17th Apr 2023

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Dental Elf – 2nd Dec 2020

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Dental Elf – 24th Aug 2018

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