Comparing the Efficacy of Toothbrushing With and Without Interproximal Cleaning Aids: A Split-Mouth Trial

Summary

The goal of this prospective clinical trial is to evaluate whether adding interproximal cleaning aids (interproximal brush, rubber toothpick, water flosser) to regular tooth brushing improves oral hygiene outcomes and gingival health compared with tooth brushing alone in dental students with gingivitis and intact interdental papillae. The main questions it aims to answer are:

* Does the addition of interproximal cleaning aids to tooth brushing result in greater reduction of dental plaque accumulation compared with tooth brushing alone?
* Does the use of interproximal cleaning aids improve gingival bleeding outcomes compared with tooth brushing alone?
* Does the use of interproximal cleaning aids affect interdental papilla health and cause soft tissue trauma or damage?
* Do different interproximal cleaning aids influence participants' motivation and adherence to oral hygiene practices?

Researchers will compare tooth brushing alone with tooth brushing combined with three different interproximal cleaning aids (interdental brush, water flosser, and rubber toothpick) to determine whether these adjunctive methods provide additional benefits in plaque control, gingival health, preservation of interdental soft tissues, and participant motivation.

Participants will:

* Perform standardized tooth brushing using the modified Bass technique twice daily.
* Use the assigned interproximal cleaning aid (interdental brush, water flosser, or rubber toothpick) in designated quadrants according to standardized instructions.
* Attend clinical evaluations at baseline and after 7, 14, and 28 days.
* Undergo assessment of dental plaque score, gingival bleeding score, interdental papilla condition, and motivation related to oral hygiene practices.

Conditions

• Gingivitis
• Dental Plaque
• Periodontal Disease

Interventions

BEHAVIORAL

Tooth Brushing Alone (Control)

Participants received standardized tooth brushing instructions using the Modified Bass technique twice daily after the last meal. No additional interproximal cleaning aid was used. This arm served as the control group for comparison with adjunctive interproximal cleaning interventions.

DEVICE

Water flosser

Participants used a water flosser as an adjunct to tooth brushing. The device was applied along the gingival margin using the continuous soft mode.

DEVICE

Interproximal Brush

Participants used an interproximal brush as an adjunct to tooth brushing. The brush was inserted into interdental spaces and moved back and forth five times per site.

DEVICE

Rubber Toothpick

Participants used a rubber toothpick as an adjunct to tooth brushing for interdental cleaning according to the manufacturer's instructions.

Sponsors & Collaborators

• Saint-Joseph University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

CROSSOVER

Eligibility

Min Age

20 Years

Max Age

23 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-10-28

Primary Completion

2026-03-22

Completion

2026-04-15

Countries

• Lebanon

Study Locations