Association of toothbrushing and proximal cleaning with periodontal health among Korean adults: Results from Korea National Health and Nutrition Examination Survey in year 2010 and 2012

J Clin Periodontol. 2018 Mar;45(3):322-335. doi: 10.1111/jcpe.12846. Epub 2018 Jan 25.


Aim: Toothbrushing (TB), dental flossing (DF) and inter-dental brushing (IDB) are regarded as fundamental self-care methods for periodontal health. Few evidences on its effectiveness on periodontal health are available. Hence, this study aimed to evaluate the association of TB, DF, IDB and interaction effect with periodontal health.

Materials and methods: The nationally representative 4,766 Korean adults aged 19 years and older were cross-sectionally surveyed in 2010 and 2012. Periodontal health was defined as Community Periodontal Index 1-2 for gingivitis and 3-4 for periodontitis. The information about variables was from interview and blood analyses. Multivariable logistic regression analyses and the interaction effect between TB and proximal cleaning (PC: DF and/or IDB) were applied.

Results: Toothbrushing thrice or more per day and DF were associated with a lower prevalence of periodontitis by both 44%, while the preventive fraction of DF on gingivitis was 30%. The preventive fraction of interaction effects between TB thrice or more and PC were 78% for periodontitis and 68% for gingivitis among 40-59 year age group.

Conclusions: Toothbrushing and PC are independently associated with periodontal health. Hence, periodontists should recommend TB thrice or more per day and PC such as DF and IDB to promote periodontal health.

Keywords: dental flossing; gingivitis; inter-dental brushing; periodontitis; toothbrushing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Dental Health Surveys
  • Female
  • Gingivitis / epidemiology*
  • Gingivitis / prevention & control
  • Humans
  • Male
  • Nutrition Surveys
  • Oral Hygiene*
  • Periodontal Index
  • Periodontitis / epidemiology*
  • Periodontitis / prevention & control
  • Prevalence
  • Republic of Korea / epidemiology
  • Toothbrushing*