The purpose of this systematic review was to evaluate the efficiency of interdental brushes and dental floss as adjuncts to toothbrushing for reducing gingival bleeding and dental plaque. Included studies were randomized controlled trials, including split mouth and crossover trials. Four papers were included for the analysis on bleeding outcome and seven papers for the analysis on plaque outcome. The results indicate that the interdental brush is more efficient than dental floss for reducing both bleeding and plaque.

 

The article presents an instructive flowchart, containing practical guidelines for choosing interdental cleaning device for the patient with interdental inflammation. First, assess the patient’s level of dexterity and motivation for daily interdental self-care. If the patient has good dexterity and/or is motivated, the next step is to determine the embrasure type. For patients with type I embrasures, dental floss should be recommended. With embrasures of type II or III, the interdental brush is the correct choice.

 

If the patient, on the other hand, has poor dexterity and/or lacks motivation, the appropriate recommendation is interdental brushes, regardless of type I, II or III embrasures. The authors conclude that the interdental brush is an effective alternative to dental floss, for reducing interproximal bleeding and plaque in booth filled and open embrasures.