King's College London

Research portal

Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures

Research output: Contribution to journalArticle

Standard

Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures. / Longbottom, Christopher.

In: Evidence-Based Dentistry, Vol. 7, No. 3, 2006, p. 68-68.

Research output: Contribution to journalArticle

Harvard

Longbottom, C 2006, 'Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures', Evidence-Based Dentistry, vol. 7, no. 3, pp. 68-68. https://doi.org/10.1038/sj.ebd.6400425

APA

Longbottom, C. (2006). Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures. Evidence-Based Dentistry, 7(3), 68-68. https://doi.org/10.1038/sj.ebd.6400425

Vancouver

Longbottom C. Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures. Evidence-Based Dentistry. 2006;7(3):68-68. https://doi.org/10.1038/sj.ebd.6400425

Author

Longbottom, Christopher. / Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures. In: Evidence-Based Dentistry. 2006 ; Vol. 7, No. 3. pp. 68-68.

Bibtex Download

@article{af5f171474714f99bfa4010e3fe6cf70,
title = "Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures",
abstract = "Data sources: Searches were made for data using Medline, the Cochrane Central Register of Controlled Trials, Web of Science and the controlled-trials database of clinical trials (www.controlled_trials.com). Reference lists of potentially relevant reports and review articles were also searched. Attempts to obtain missing information and 'grey' literature were made through contact with selected investigators.Study selection: The treatment comparisons of interest included flossing versus no flossing, or a comparison of different frequencies of flossing use. Studies where the effect of flossing could not be separated from the effects of other treatments were excluded. The primary study outcome was a measure of caries incidence. There were no restrictions with respect to the study population. Study designs were limited to controlled clinical trials.Data extraction and synthesis: Quality assessment was performed by evaluating the following items: random allocation, treatment allocation concealment, blinding of outcomes assessors, presentation of point estimates with a measure of variability for the primary outcome measure, 'intention to treat' analysis, report of baseline characteristics by treatment group, eligibility criteria, loss to follow-up, and missing values. For each trial, the number of surfaces at risk and the number of new interproximal caries lesions were derived from or estimated based on published data. Both relative risk (RR) and risk difference and their respective standard deviations were calculated. Heterogeneity was assessed with the I2 statistic (describes the percentage of the variability in effect estimates that is due to heterogeneity rather than sampling error. A value greater than 50{\%} may be considered substantial heterogeneity). The effect of study characteristics such as fluoride, oral hygiene or caries risk on flossing effectiveness was estimated by meta-regression. Subgroup analyses and sensitivity analyses were also conducted.Results: The search identified 144 articles, of which six met the inclusion criteria. A total of 808 subjects, aged 4 to 13 years, were included in the meta-analysis. There were significant study-to-study differences and a moderate to large potential for bias. Professional flossing performed on school days for 1.7 years on predominantly primary teeth in children was associated with a 40{\%} caries risk reduction [RR, 0.60; 95{\%} confidence interval (CI), 0.48–0.76; P<0.001]. Both 3-monthly professional flossing for 3 years (RR, 0.93; 95{\%} CI, 0.73–1.19; P 0.32) and self-performed flossing in young adolescents for 2 years (RR, 1.01; 95{\%} CI, 0.85–1.20; P 0.93) did not reduce caries risk. No flossing trials in adults or under unsupervised conditions could be identified.Conclusions: Professional flossing in children with low fluoride exposures is highly effective in reducing interproximal caries risk. These findings should be extrapolated to more typical floss-users with care, since self-flossing has failed to show an effect.",
author = "Christopher Longbottom",
year = "2006",
doi = "10.1038/sj.ebd.6400425",
language = "English",
volume = "7",
pages = "68--68",
journal = "Evidence-Based Dentistry",
issn = "1462-0049",
publisher = "Nature Publishing Group",
number = "3",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Professional flossing is effective in reducing interproximal caries risk in children who have low fluoride exposures

AU - Longbottom, Christopher

PY - 2006

Y1 - 2006

N2 - Data sources: Searches were made for data using Medline, the Cochrane Central Register of Controlled Trials, Web of Science and the controlled-trials database of clinical trials (www.controlled_trials.com). Reference lists of potentially relevant reports and review articles were also searched. Attempts to obtain missing information and 'grey' literature were made through contact with selected investigators.Study selection: The treatment comparisons of interest included flossing versus no flossing, or a comparison of different frequencies of flossing use. Studies where the effect of flossing could not be separated from the effects of other treatments were excluded. The primary study outcome was a measure of caries incidence. There were no restrictions with respect to the study population. Study designs were limited to controlled clinical trials.Data extraction and synthesis: Quality assessment was performed by evaluating the following items: random allocation, treatment allocation concealment, blinding of outcomes assessors, presentation of point estimates with a measure of variability for the primary outcome measure, 'intention to treat' analysis, report of baseline characteristics by treatment group, eligibility criteria, loss to follow-up, and missing values. For each trial, the number of surfaces at risk and the number of new interproximal caries lesions were derived from or estimated based on published data. Both relative risk (RR) and risk difference and their respective standard deviations were calculated. Heterogeneity was assessed with the I2 statistic (describes the percentage of the variability in effect estimates that is due to heterogeneity rather than sampling error. A value greater than 50% may be considered substantial heterogeneity). The effect of study characteristics such as fluoride, oral hygiene or caries risk on flossing effectiveness was estimated by meta-regression. Subgroup analyses and sensitivity analyses were also conducted.Results: The search identified 144 articles, of which six met the inclusion criteria. A total of 808 subjects, aged 4 to 13 years, were included in the meta-analysis. There were significant study-to-study differences and a moderate to large potential for bias. Professional flossing performed on school days for 1.7 years on predominantly primary teeth in children was associated with a 40% caries risk reduction [RR, 0.60; 95% confidence interval (CI), 0.48–0.76; P<0.001]. Both 3-monthly professional flossing for 3 years (RR, 0.93; 95% CI, 0.73–1.19; P 0.32) and self-performed flossing in young adolescents for 2 years (RR, 1.01; 95% CI, 0.85–1.20; P 0.93) did not reduce caries risk. No flossing trials in adults or under unsupervised conditions could be identified.Conclusions: Professional flossing in children with low fluoride exposures is highly effective in reducing interproximal caries risk. These findings should be extrapolated to more typical floss-users with care, since self-flossing has failed to show an effect.

AB - Data sources: Searches were made for data using Medline, the Cochrane Central Register of Controlled Trials, Web of Science and the controlled-trials database of clinical trials (www.controlled_trials.com). Reference lists of potentially relevant reports and review articles were also searched. Attempts to obtain missing information and 'grey' literature were made through contact with selected investigators.Study selection: The treatment comparisons of interest included flossing versus no flossing, or a comparison of different frequencies of flossing use. Studies where the effect of flossing could not be separated from the effects of other treatments were excluded. The primary study outcome was a measure of caries incidence. There were no restrictions with respect to the study population. Study designs were limited to controlled clinical trials.Data extraction and synthesis: Quality assessment was performed by evaluating the following items: random allocation, treatment allocation concealment, blinding of outcomes assessors, presentation of point estimates with a measure of variability for the primary outcome measure, 'intention to treat' analysis, report of baseline characteristics by treatment group, eligibility criteria, loss to follow-up, and missing values. For each trial, the number of surfaces at risk and the number of new interproximal caries lesions were derived from or estimated based on published data. Both relative risk (RR) and risk difference and their respective standard deviations were calculated. Heterogeneity was assessed with the I2 statistic (describes the percentage of the variability in effect estimates that is due to heterogeneity rather than sampling error. A value greater than 50% may be considered substantial heterogeneity). The effect of study characteristics such as fluoride, oral hygiene or caries risk on flossing effectiveness was estimated by meta-regression. Subgroup analyses and sensitivity analyses were also conducted.Results: The search identified 144 articles, of which six met the inclusion criteria. A total of 808 subjects, aged 4 to 13 years, were included in the meta-analysis. There were significant study-to-study differences and a moderate to large potential for bias. Professional flossing performed on school days for 1.7 years on predominantly primary teeth in children was associated with a 40% caries risk reduction [RR, 0.60; 95% confidence interval (CI), 0.48–0.76; P<0.001]. Both 3-monthly professional flossing for 3 years (RR, 0.93; 95% CI, 0.73–1.19; P 0.32) and self-performed flossing in young adolescents for 2 years (RR, 1.01; 95% CI, 0.85–1.20; P 0.93) did not reduce caries risk. No flossing trials in adults or under unsupervised conditions could be identified.Conclusions: Professional flossing in children with low fluoride exposures is highly effective in reducing interproximal caries risk. These findings should be extrapolated to more typical floss-users with care, since self-flossing has failed to show an effect.

U2 - 10.1038/sj.ebd.6400425

DO - 10.1038/sj.ebd.6400425

M3 - Article

C2 - 17003792

VL - 7

SP - 68

EP - 68

JO - Evidence-Based Dentistry

JF - Evidence-Based Dentistry

SN - 1462-0049

IS - 3

ER -

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454