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The effects of flossing with a chlorhexidine solution on interproximal gingivitis : a randomized controlled trial Imai, Pauline H.


Background: Gingivitis, which is an inflammatory response of the gingival tissues to bacterial plaque, can be treated by brushing and flossing or using chlorhexidine (CHX). Objective: To determine whether floss presoaked in CHX would improve oral health relative to floss presoaked in placebo solution. Materials and methods: A 3 month, double-blinded, parallel, randomized control trial was conducted on 27 adults with a minimum of 10 bleeding sites, who were randomly assigned to dental floss with 0.12% CHX or a placebo solution (QS). Scaling, rubber cup prophylaxis, and flossing instructions were performed at Week -1. Subjects were assessed for probing depth (PD) with bleeding on probing (BOP), gingival index (GI), plaque index (PI), and stain index (SI) at Weeks 0, 6, and 12. Flossing compliance was monitored by self-reports and yards of dental floss used. Student t-tests, ANCOVA and Wilcoxon Signed-Rank were conducted. Results: Self-reported median flossing compliance was 100% for CHX and 93% for QS. A statistically significant reduction for PD in the CHX group at Week 6 (p = 0.029) and specifically, for the gingivitis sites at Week 6 (p = 0.006) and Week 12 (p = 0.005). Reductions in BOP were statistically significant for CHX group with moderate gingivitis (p = 0.0078). The CHX group had a statistically significant reduction in BOP in all areas of the oral cavity with the largest reductions occurring in the anterior areas (p = 0.011). All GI scores were statistically significant from Weeks 0 to 12 (p < 0.0001). Although not statistically significant, PI appeared to be constant for CHX group and increasing for QS group. The two groups did not differ significantly for SI. Conclusion: CHX applied via dental floss significantly reduced probing depths in shallow sulci and bleeding in subjects with moderate gingivitis. Further studies are suggested to determine the effects of CHX with different interdental aids, higher concentrations of CHX, and subjects with moderate to severe gingivitis. Funding: CFDHRE and BCDHA Key words: gingivitis, chlorhexidine, dental floss, RCT, bleeding on probing, gingival and plaque indices.

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