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Objectives: The purpose of this clinical trial was to compare the use of a manual toothbrush plus water flosser to a manual toothbrush alone on clinical signs of inflammation., Methods: Seventy-two subjects were randomized into two groups and completed this four-week, single-blind, parallel, clinical trial. Group 1 used a Waterpik®Water Flosser (WF) once daily and brushed with a manual toothbrush twice a day. Group 2 brushed twice a day with a manual toothbrush only (MT). Subjects in group 1 were provided written and verbal instructions for the water flosser and all participants used the toothpaste and manual brush provided, brushing as they normally do. Data were evaluated at baseline (BSL), two weeks (W2), and four weeks (W4) for bleeding on probing (BOP), Modified Gingival Index (MGI), and Rustogi Modification of the Navy Plaque Index (RMNPI)., Results: Both groups showed a significant reduction from BSL for BOP, MGI, and RMNPI at W2 and W4, except for MT W2 facial proximal MGI (p = 0.153) and marginal RMNPI (p = 0.324). The WF was significantly more effective than the MT for reducing BOP, MGI, and RMNPI at W2 and W4 for all areas measured. The WF was 3.13 times as effective for reducing BOP, 2.69 times for MGI, and 2.44 times for RMNPI at W4 (p < 0.001) for whole mouth scores., Conclusions: The addition of the Waterpik®Water Flosser to manual tooth brushing is significantly more effective for improving gingival health than manual tooth brushing alone., Competing Interests: C. Ram Goyal and Jimmy G. Qaqish are employed by All Sum Research Center. Reinhard Schuller is employed by Reinhard Schuller Consulting. Deborah M. Lyle is employed by Waterpik, Inc., (Copyright© by the YES Group, Inc.)

Objectives: To evaluate and compare the efficacy of a marketed oscillating-rotating electric rechargeable toothbrush to a marketed sonic toothbrush in the reduction of gingivitis and plaque over an 8-week period., Methods: This was a randomized, examiner-blind, parallel group, eight-week study. Subjects with presence of mild-to-moderate plaque and gingivitis received an oral examination and were evaluated for baseline gingivitis (Modified Gingival Index; MGI), gingival bleeding (Gingival Bleeding Index; GBI), and plaque (Rustogi Modified Navy Plaque Index). Qualified subjects were randomly assigned to an entry-level oscillating-rotating electric rechargeable brush handle (Oral-B® PRO 1000, D16U) with a round brush head with angled bristles (Oral-B® CrossAction, EB50) or a premium sonic brush (Philips Sonicare® Diamond Clean Toothbrush with AdaptiveClean brush head). One hundred and fifty subjects were instructed to brush twice daily with their assigned brush and a fluoride dentifrice for eight weeks before returning for an oral examination and gingivitis and plaque evaluations. The same methods were used at baseline and Week 8 for all evaluations., Results: One hundred and forty-eight subjects completed the study, 74 in each group. After eight weeks of use, both brushes reduced MGI, GBI, total number of bleeding sites, whole mouth plaque, gingival margin plaque, and proximal plaque (p < 0.001 for each). The oscillating-rotating brush provided statistically significantly greater reductions than the sonic brush for all gingivitis measures, with a 34.8%, 48.4%, and 42.6% greater reduction for MGI, GBI, and number of bleeding sites, respectively, after eight weeks of use (p < 0.001 for each). Significantly greater whole mouth (26.2%) and proximal (38.5%) plaque reductions were also demonstrated at Week 8 for the oscillating-rotating brush versus the sonic brush (p < 0.001)., Conclusions: The entry-level oscillating-rotating brush performed better than the premium sonic brush in the reduction of plaque and gingivitis in this eight-week randomized and examiner-blind study., Competing Interests: Dr. Ccahuana-Vasquez, Ms. Conde, Ms. Cunningham, and Dr. Grender are employees of Procter & Gamble. Dr. Goyal and Mr. Qaqish have no conflicts to disclose. The research was funded by Procter & Gamble., (Copyright© by the YES Group, Inc.)