Is it time to reconsider how to floss implants?

The best home care modality for implants may not be string floss.

Dental floss as a possible risk factor for the development of peri-implant disease: an observational study of 10 cases

In Clinical Oral Implants Research reviewed 10 cases involving patients from the Netherlands, who had been receiving regular implant maintenance therapy and still suffered from progressive peri-implantitis. The patients all underwent flap surgery to treat the defect. In each case, surgery revealed the remnants of dental floss around the roughened surface of the implant. Microbiological samples found a significant increase in the Fuso-bacterium nucleatum species.

Post surgically, 9 of the 10 cases significantly improved; bleeding disappeared and pocketing decreased.  To test their hypothesis regarding dental floss as the irritant, the researchers exposed a pristine implant to 10 seconds of rubbing with dental floss or Superfloss® and examined the implants under a scanning electron microscope. They found large amounts of floss fibers on the implants along with wax.

Does this mean that floss should not be recommended for implants? Not necessarily as the study was limited to case reports on 10 people. As with any oral hygiene modality, the patient's oral health situation, scientific evidence on the product, and abilities need to be taken into consideration.

van Velzen F, et al Clinical Oral Implants Research, August 2015.

Waterpik® Water Flosser more than 2x as effective as string floss for reducing bleeding around implants

A study conducted at Tufts University compared the use of a manual toothbrush and either a Water Flosser or string floss to see which regimen was most effective at improving the health around implants. After 30 days, the people who used a Water Flosser had a 145% better reduction in bleeding around implants versus those using string floss.

In this study, water flossing was delivered via the Plaque Seeker® Tip at the 6 (medium) pressure setting. The Plaque Seeker® Tip has three thin tufts of bristles to access stubborn plaque around implants, crowns, and bridges. To learn more about how the Water Flosser can improve implant health, click here to request a lunch and learn.

Magnuson B et al, Compendium Continuing Education Dentistry, Nov/Dec 2013.

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