Langa GPJ et al.

Interdental cleaning is a cornerstone in the effort to disrupt and remove plaque and prevent and treat gingivitis in the area between the teeth. This systematic review explored the possible beneficial effects of using interdental cleaning devices combined with active substance. The results were based on five studies using floss combined with chlorhexidine, one study on interdental brushes with chlorhexidine, and one with interdental brushes combined with cetylpyridinium chloride. All interdental cleaning devices were used as an adjunct to a standard soft-bristled toothbrush

Comparisons were made between three regimes:

• toothbrushing and interdental cleaning device with an active substance
• toothbrushing and interdental cleaning device without an active substance
• toothbrushing alone

Overall, very low certainty of the evidence was demonstrated for all comparisons. However, based on the outcomes of the studies, the authors conclude that adding active substances does not contribute to any enhanced clinical benefits regarding antigingivitis and antiplaque effectiveness compared to interdental cleaning devices used without active substances. Nevertheless, floss combined with chlorhexidine might positively impact the removal of plaque. They also state that interdental cleaning devices might have a positive impact in comparison with toothbrushing alone.