Comparison of Water Flosser and Interdental Brush on Plaque Removal: A Single-Use Pilot Study

J Clin Dent. 2016 Mar;27(1):23-26.


Objectives: The purpose of this randomized, single-use, single-blind, two-group, parallel pilot study was to compare the plaque removal ability of a water flosser and interdental brush when used in combination with a manual toothbrush.

Methods: Twenty-eight (28) subjects completed the study. Subjects were randomly assigned to one of two groups: Waterpik®Water Flosser (WF) plus manual tooth brushing or interdental brushes (IDB) plus manual tooth brushing. Pre-cleaning plaque scores were obtained using the Rustogi Modification of the Navy Plaque Index (RMNPI). Subjects were instructed on the use of their interdental product. Post-cleaning scores were obtained after a supervised brushing and use of the interdental device. Scores were recorded for whole mouth, marginal, approximal, facial, and lingual regions for each subject.

Results: There were no differences between the groups for pre-cleaning plaque scores for whole mouth, marginal, approximal, facial, or lingual regions. Both groups showed significant reductions in plaque from baseline for all areas measured (p < 0.001). The WF group was significantly more effective than the IDB group for removing plaque from all areas measured. Specifically, the WF was 18% more effective for whole mouth and marginal areas, 20% for approximal areas, 11% for facial areas, and 29% for lingual areas.

Conclusions: The Waterpik Water Flosser and manual toothbrush removes significantly more plaque from tooth surfaces (whole mouth, marginal, approximal, facial, and lingual) than interdental brushes and a manual toothbrush after a single use.

Keywords: Waterpik; approximal; binterproximal brush; biofilm; interdental; interdental brush; interproximal; plaque; water flosser.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Devices, Home Care*
  • Dental Plaque Index
  • Dental Plaque*
  • Equipment Design
  • Humans
  • Pilot Projects
  • Single-Blind Method
  • Toothbrushing*
  • Water


  • Water