Waterpik® Water Flosser: Using the water flosser to deliver a dilute of CHX improves periodontal pocket depth and clinical attachment levels better than rinsing with CHX

Evaluation of the efficacy of subgingival irrigation in patients with moderate-to-severe chronic periodontitis otherwise indicated for periodontal flap surgeries.

Jain R, Chaturvedi R, Pandit N, Grover V, Lyle DM, Jain A. J Indian Soc Periodontol 2020; 24(4):348-353. Study conducted at Institute of Dental Services, Panjab University, Chandigarh, India.

Objective

To evaluate the efficacy of a water flosser and toothbrush using 0.06% chlorhexidine (CHX) with Pik Pocket® tip compared to 0.12% rinse and toothbrush in moderate-to-severe chronic periodontitis patients who postponed or declined surgical intervention.

Methodology

Forty subjects (40) were enrolled in this 3-month, randomised controlled clinical trial.

Subjects were assigned to one of two groups: Group A was instructed to irrigate with 0.06% CHX twice a day after brushing and Group B was instructed to rinse with 15 ml of 0.12% CHX twice a day after brushing.

All subjects received Phase I therapy consisting of scaling, root planing and oral hygiene instructions specific to their device and a standard manual toothbrush and toothpaste.

Gingival index (GI), oral hygiene index simplified (OHIS) and bleeding on probing (BOP) scores were recorded at baseline, 2 weeks, 4 weeks and 12 weeks post Phase I therapy.

Pocket depth (PD) and clinical attachment level (CAL) were recorded on 6 sites per tooth. The modification of Lobene stain index was used to assess intensity and area for each subject to monitor the staining by CHX.

Results

Thirty-six (36) subjects completed the study. Both groups showed a significant difference from baseline to 12 weeks for GI, OHIS and BOP. There were no differences between the groups. Group A, irrigation with 0.06% CHX, was more effective than Group B, rinsing with 0.12% CHX, for reducing PD and CAL.

Group A had significantly less staining on the lingual surface than Group B (p=0.014).

Conclusion

Waterpik® Water Flossing with 0.06% CHX and Pik Pocket® tip twice a day can significantly improve periodontal health status.