September 2013

When Floss is Not Enough

  • The 6 mm or greater pocket
  • Furcations
  • Implants
  • Crown and Bridge

Periodontal maintenance patients need to practice optimal self-care to maintain good oral health and prevent further bone breakdown. This can be challenging because many will have areas that are difficult to access and remove biofilm. Anatomically, even the most skilled flosser is not going to be able to get floss to reach much beyond 3 mm or into a furcation.

The Waterpik® Water Flosser is an ideal choice for periodontal maintenance patients. The device has been evaluated on periodontal maintenance patients in numerous studies and has been shown to consistently reduce bleeding and gingival inflammation in this patient base. In a comprehensive look at how water irrigation via the Water Flosser benefits periodontal maintenance patients, Cutler et al found that the daily use of the Water Flosser with water delivered by the Classic Jet Tip at a medium pressure setting significantly reduced plaque, bleeding, gingivitis, and probing depth in as little as 2 weeks. The investigators also analyzed the gingival crevicular 8 hours post irrigation and found that it contained significantly less of the type of inflammatory mediators associated with bone loss.

For patients with implants, the Water Flosser it has been shown to be more effective than string floss for reducing bleeding around implants. Magnuson et al found that after 30 days the Water Flosser reduced bleeding in 81.8% of implants compared to only 33.3% for string floss.

To learn more about how the Water Flosser can benefit periodontal maintenance patients, click here to take the Periodontal Maintenance self-study.

Perio Patients & the Water Flosser:
Myth or Fact

  1. A Water Flosser used on high will drive bacteria deeper into the pocket.
  2. A Water Flosser should always be used on low or else it will deepen pockets.
  3. A Water Flosser is safe and effective on implants.

The Answers

  • Question 1. - MYTH
    The pulsating action of the Waterpik® Water Flosser creates a compression/decompression phase that safely and effectively disrupts plaque, bacteria, and debris up to 6 mm. A seminal study by Cobb et al found that pockets treated with the Water Flosser had less bacteria up to 6 mm. The soft tissue walls of these pockets showed no signs of trauma, ulceration, or bacterial penetration. Likewise, Drisko et al found spirochetes were reduced up to 6 mm with the Water Flosser.
  • Question 2. - MYTH
    Numerous studies have been conducted on patients in periodontal maintenance. No study outcome has found that the Water Flosser increased pocket depth. Rather, the studies find that the Water Flosser stabilizes the pockets of periodontal maintenance patients. Some studies, such as those by Cutler et al, Newman et al and Flemmig et al have shown that the daily use of the Waterpik® Water Flosser with plain water at a medium high setting significantly reduced probing depth.
  • Question 3. - FACT
    A recent study on implants conducted at Tufts University found that the Water Flosser with the Plaque Seeker® Tip set at medium pressure was 145% more effective than string floss at reducing bleeding on probing. No trauma or harm to the implants was reported. To learn more facts about the Waterpik® Water Flosser, click here to access the Water Flosser self-study.