Waterpik^™ Water Flosser Significantly Alters the Subgingival Microbiome Composition Towards a Periodontally Healthy Community Better than String Floss

Objective

To evaluate the effect of different water flossers on the subgingival microbiome composition in patients with naturally occurring gingivitis.

Methodology

Subgingival plaque was collected from thirty-six adults participating in a clinical trial assessing the efficacy of oral hygiene with two different water flossers (Waterpik^TM ION water flosser and Oral-B® Advanced water flosser) versus dental flossing for microbiome analysis. Samples were collected at baseline and week 4. The microbiome was analyzed by 16S rRNA sequencing to identify amplicon sequence variants. Click here for information on the clinical trial that accompanied this microbiome evaluation.

Results

Both water flosser groups demonstrated slight yet critical changes in the subgingival microbiome composition over string floss. Group comparisons saw the Waterpik^TM ION water flosser demonstrates a great reduction in periodontal pathogens and higher abundance of commensal bacteria over both the Oral-B® Advanced and string floss. Notably, only the Waterpik^TM group demonstrated a substantial reduction in multiple species of the anaerobic bacteria, Porphyromonas. Compared to string floss, the Waterpik^TM water flosser users also had greater reduction of multiple Treponema species.

Conclusion

Water flossing outperforms string flossing at changing the composition of the subgingival microbiome to one associated with gingival health. The Waterpik^TM water flosser was associated with a higher abundance of commensal bacteria and reduction in periodontal pathogens over the Oral-B® water flosser.

This is an open access article freely available via the Journal of Clinical Periodontology. Click here to access the full article.