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    Parroting the flossing message

    Interdental hygiene recommendations are constantly changing, so staying up to date on the latest research can help you provide better patient care.

    Every time I work a clinical day, I ask my adult patients — new and recare — how they approach the daily disruption of oral biofilm. The answer I get from “slackers” is always the same: I brush twice a day and I don’t always floss as often as I should. If I bottled this message and threw it in the ocean every time I heard it, I’d be contributing to some serious ocean pollution!

    Why are patients habitual parrots, regularly vocalizing what they think they should do when it comes to daily string flossing?

    Are we (dental professionals) at fault when we hear this mantra coming from our patients? Yes, I think we are, in part, and the one way to change it is to modify the message.

    Evidence-based professionals regularly look at systematic reviews and I found an excellent summary and appraisal of evidence to date on the efficacy of various interdental devices for mechanical biofilm removal in managing gingivitis.1 There is moderate evidence to support the efficacy of interdental brushes on biofilm removal and reduction of gingivitis but only weak evidence supporting the use of dental floss, woodsticks and the oral irrigator.

    More from the author: Why it's important to include periodontal probing in a hygiene appointment

    The message is clear: Dental floss in the goody bag is not always a good choice and it would be better to customize an interdental brush for our adult patients and drop one in the goody bag instead.

    I recently attended the Georgia Dental Hygienists’ Association (GDHA) Annual Session and had the pleasure of listening to Michelle Strange, RDH, an educator for TePe Oral Health Care. Michelle is very entertaining in a refreshing and creative way and she discussed the morphology of teeth, including embrasures, and offered a lot of practical suggestions for dental professionals. TePe offers an array of interdental brushes with nine sizes (brush diameter) for embrasure customization.

    I decided to follow-up with Michelle and ask her some questions about some of the positive changes I’ve observed in interdental self care recommendations.

    1. There’s been a huge shift in hygiene recommendations for patients in all age groups when it comes to biofilm disruption in proximal areas. Can you discuss the various changes in the different age groups?

    In the U.S., we are seeing a paradigm shift from begging our patients to floss and seeing them continue to not floss to finding something the patient will and can do to maintain the proximal surfaces. This is such a great shift because parents can now help their young children without having to put their hands in their child's mouth with a piece of floss. The aging population now has options to fit their level of dexterity and fine motor skills. Even caregivers can benefit from the different options for proximal home care. Proximal surfaces have always been a difficult area for patients to maintain and require a high level of skill and motivation. We can now find products that can be used anywhere, at anytime and are easier to use, thus increasing motivation and compliance. 

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