Evaluation of floss types for interproximal plaque removal

Am J Dent. 2000 Aug;13(4):212-4.


Purpose: To evaluate the efficacy of four different floss types for interproximal plaque removal on the normal dentition.

Materials and methods: 24 dental hygiene students tested each of four different floss types: waxed, unwaxed, woven and shred-resistant. At baseline, all subjects received a prophylaxis to become plaque-free and identical flossing instructions were given. Subjects were then instructed not to brush, floss, or rinse for 3 days to allow for plaque development. On the fourth day, each subject's teeth were disclosed and scored using O'Leary's Plaque Index. Subjects were then randomly assigned one of the four floss types to use throughout the dentition, following which a second plaque record was assessed. Subjects were timed while flossing, and then completed a 10 cm Visual Analogue Scale (VAS) scoring their degree of discomfort/comfort and ease of use for each specific type of floss. This protocol was followed until all four floss types were tested by each subject. Results analyzed reductions in total interproximal plaque score (TIPS), anterior (teeth) interproximal plaque score (AIPS), and posterior (teeth) interproximal plaque score (PIPS).

Results: The greatest reduction in TIPS and PIPS was with waxed floss (68.87%, 66.54% respectively) and in AIPS with woven floss (75.15%). Post-hoc testing using Tukey's method revealed no significant differences among the four floss types. VAS scores revealed shred-resistant most comfortable (6.99) while unwaxed was least (4.29). These results indicated minimal differences in the efficacy of different types of floss, their degree of comfort and ease of use.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Coloring Agents
  • Dental Devices, Home Care* / classification
  • Dental Plaque / pathology
  • Dental Plaque / therapy*
  • Dental Plaque Index
  • Dental Prophylaxis
  • Double-Blind Method
  • Equipment Design
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Oral Hygiene / instrumentation
  • Patient Satisfaction
  • Statistics as Topic
  • Surface Properties
  • Time Factors
  • Treatment Outcome


  • Coloring Agents