Oral irrigator

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An oral irrigator Water Flosser.jpg
An oral irrigator

An oral irrigator (also called a dental water jet, water flosser or, by the brand name of the best-known such device, Waterpik) is a home dental care device which uses a stream of high-pressure pulsating water intended to remove dental plaque and food debris between teeth and below the gum line. Regular use of an oral irrigator is believed to improve gingival health. The devices may also provide easier cleaning for braces and dental implants. [1] However, more research is needed to confirm plaque biofilm removal and effectiveness when used by patients with special oral or systemic health needs. [2]

Contents

History

The first oral irrigator was developed in the 1950s by Dr. C.D. Matteson, who patented the invention in 1955. [3] Dr. Matteson's invention was designed to cleanse the teeth and gums after meals as an alternative to using hand syringes. It attached directly to a sink's faucet and featured a mechanical valve to control water pressure. [4]

Later, in 1962, dentist Gerald Moyer and engineer John Mattingly invented Waterpik. The Waterpik featured a built in reservoir and motor to pump water out of a tip at rhythmic pulses. [5] The Waterpik is now sold by Water Pik, Inc. [6]

Efficacy

Oral irrigators have been evaluated in a number of scientific studies and have been tested for periodontal maintenance, [7] and those with gingivitis, diabetes, orthodontic appliances, and tooth replacements such as crowns, and implants. [2]

A 2008 systematic review found improvement in gingival health with irrigation compared with regular oral hygiene, although there was no reduction in plaque. [8] A 2019 meta-analysis found that water-jet irrigation is more effective at reducing bleeding on probing than flossing. [9]

Other uses

Oral irrigators have also been used to remove tonsil stones ("tonsiloliths") in those subject to them. [10]

Mode of operation

Most oral irrigators use a single stream of water to flush unwanted material from between the teeth. Compared to flossing, oral irrigators are also ideal for narrow teeth or hard-to-reach areas between teeth.

The market also offers devices in which it is possible to specifically massage the gums using sophisticated massage heads. In addition, mouthwash solution can be injected into periodontal pockets using the sub-gingival nozzle, used as a nozzle.

Cleaning technique

After filling the reservoir with water, point the nozzle close to the gum line at an angle of 90 degrees. [11] Then start the device by setting the appropriate pressure value. It is recommended to start irrigation from the back teeth, slowly following the gum line. The water jet should be directed between the tooth spaces, surfaces above the gum line, stopping momentarily at the area to be cleaned. In the case of hard-to-reach areas such as when using braces, in gum pockets, the angle of the nozzle can be changed. [12]

Criticism

Dentists classify the oral irrigator as a wellness product because it cannot replace medically sensible brushing and flossing. There is only a possible improvement in blood circulation in the gums due to the massage effect. On the other hand, there is a risk that food debris will get into the tooth pockets due to improper use ("flushing the tooth pockets") and damage the teeth and gums there. Because of this risk, most dentists do not recommend the use of oral irrigators. [13] Many dentists advise against usage of an irrigator for people with gum disease or have had a tooth extraction.

However, other studies have shown that oral irrigators are better at removing plaque than flossing. [14]

See also

Related Research Articles

<span class="mw-page-title-main">Periodontal disease</span> Medical condition

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Bad breath may also occur.

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

<span class="mw-page-title-main">Dental floss</span> Cord of thin filaments used in interdental cleaning

Dental floss is a cord of thin filaments used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use as part of oral cleaning is designed to maintain oral health.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.

<span class="mw-page-title-main">Gingival sulcus</span> Space between tooth and gums

The gingival sulcus is an area of potential space between a tooth and the surrounding gingival tissue and is lined by sulcular epithelium. The depth of the sulcus is bounded by two entities: apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival margin. A healthy sulcular depth is three millimeters or less, which is readily self-cleansable with a properly used toothbrush or the supplemental use of other oral hygiene aids.

<span class="mw-page-title-main">Tooth brushing</span> Act of scrubbing teeth with a toothbrush

Tooth brushing is the act of scrubbing teeth with a toothbrush equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene. The recommended amount of time for tooth brushing is two minutes.

<span class="mw-page-title-main">Gingival and periodontal pocket</span>

Gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival tissue contacts the tooth.

Bleeding on probing (BoP) which is also known as bleeding gums or gingival bleeding is a term used by dentists and dental hygienists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth. BoP is a sign of periodontal inflammation and indicates some sort of destruction and erosion to the lining of the sulcus or the ulceration of sulcular epithelium. The blood comes from lamina propria after the ulceration of the lining. BoP seems to be correlated with Periodontal Inflamed Surface Area (PISA).

<span class="mw-page-title-main">Scaling and root planing</span> Dental procedure

Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning, is a procedure involving removal of dental plaque and calculus and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms, the agents that cause inflammation. It is a part of non-surgical periodontal therapy. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.

Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth.

<span class="mw-page-title-main">Oral hygiene</span> Cleaning the mouth by brushing the teeth and cleaning in between the teeth

Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

<span class="mw-page-title-main">Periodontal abscess</span> Medical condition

A periodontal abscess, is a localized collection of pus within the tissues of the periodontium. It is a type of dental abscess. A periodontal abscess occurs alongside a tooth, and is different from the more common periapical abscess, which represents the spread of infection from a dead tooth. To reflect this, sometimes the term "lateral (periodontal) abscess" is used. In contrast to a periapical abscess, periodontal abscesses are usually associated with a vital (living) tooth. Abscesses of the periodontium are acute bacterial infections classified primarily by location.

Chronic periodontitis is one of the seven categories of periodontitis as defined by the American Academy of Periodontology 1999 classification system. Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by the accumulation of profuse amounts of dental plaque. Periodontitis initially begins as gingivitis and can progress onto chronic and subsequent aggressive periodontitis according to the 1999 classification.

<span class="mw-page-title-main">Tooth mobility</span> Medical condition

Tooth mobility is the horizontal or vertical displacement of a tooth beyond its normal physiological boundaries around the gingival area, i.e. the medical term for a loose tooth.

Laser gingivectomy is a dental procedure that recontours or scalpels the gingival tissue to improve long term dental health or aesthetics. Compared to conventional scalpel surgery, soft-tissue dental lasers, such as Laser diode, Nd:YAG laser, Er:YAG laser, Er,Cr:YSGG laser, and CO2 lasers, can perform this procedure, offering a precise, stable, bloodless, often less painful, and accelerated healing experience. However, the Laser diode gained more popularity due to its versatility, less interaction with hard tissue, ease of use, and the less expensive set up.

Interdental cleaning or interproximal cleaning is part of oral hygiene where the aim is to clean the areas in between the teeth, otherwise known as the proximal surfaces of teeth. This is to remove the dental plaque in areas a toothbrush cannot reach. The ultimate goal of interproximal cleaning is to prevent the development of interproximal caries and periodontal disease. The combined use of tooth brushing, and mechanical and manual interdental cleaning devices has been proven to reduce the prevalence of caries and periodontal diseases.

Periodontal surgery is a form of dental surgery that prevents or corrects anatomical, traumatic, developmental, or plaque-induced defects in the bone, gingiva, or alveolar mucosa. The objectives of this surgery include accessibility of instruments to root surface, elimination of inflammation, creation of an oral environment for plaque control, periodontal diseases control, oral hygiene maintenance, maintain proper embrasure space, address gingiva-alveolar mucosa problems, and esthetic improvement. The surgical procedures include crown lengthening, frenectomy, and mucogingival flap surgery.

References

  1. Ng, Ethan; Lim, Lum Peng (2019-06-01). "An Overview of Different Interdental Cleaning Aids and Their Effectiveness". Dentistry Journal. 7 (2): 6. Oral Irrigators. doi: 10.3390/dj7020056 . ISSN   2304-6767. PMC   6630384 . PMID   31159354.
  2. 1 2 Jahn, Carol A. (2010). "The dental water jet: a historical review of the literature". Journal of Dental Hygiene. 84 (3): 114–120. ISSN   1553-0205. PMID   20579423.
  3. "The Complete History of Oral Irrigation (Water Flossing) | Instafloss". 10 August 2021.
  4. US 2829645,Matteson, Clarence D.,"Hydraulic dental syringe",issued 1958-04-08
  5. Dulken, Stephen van (2004). American Inventions: A History of Curious, Extraordinary, and Just Plain Useful Patents . NYU Press. pp.  98, 99. ISBN   978-0-8147-8813-4.
  6. "About Water Pik, Inc". Water Pik, Inc.
  7. Sharma, N; Lyle, D; Qaqish, J; Galustians, J; Schuller, R (2008). "Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances". American Journal of Orthodontics and Dentofacial Orthopedics. 133 (4): 565–71, quiz 628.e1–2. doi:10.1016/j.ajodo.2007.12.008. PMID   18405821.
  8. Husseini, A.; Slot, D. E.; Weijden, GA Van der (2008). "The efficacy of oral irrigation in addition to a toothbrush on plaque and the clinical parameters of periodontal inflammation: a systematic review". International Journal of Dental Hygiene. Centre for Reviews and Dissemination (UK). 6 (4): 304–314. doi:10.1111/j.1601-5037.2008.00343.x. PMID   19138181.
  9. Kotsakis, Georgios A.; Lian, Qinshu; Ioannou, Andreas L.; Michalowicz, Bryan S.; John, Mike; Chu, Haitao (May 2018). "A Network Meta-analysis of Interproximal Oral Hygiene Methods in the Reduction of Clinical Indices of Inflammation". Journal of Periodontology. 89 (5): 558–570. doi:10.1002/JPER.17-0368. ISSN   0022-3492. PMC   5984142 . PMID   29520910. The second greatest additional reduction in BOP against control was noted for waterjet (WJ) ... Floss (FL) and automated floss (FL2) were also significantly more effective than control in reducing BOP, but the effect size was relatively small for both interventions
  10. Svoboda, Elizabeth (August 31, 2009). "In Tonsils, a Problem the Size of a Pea". The New York Times. Retrieved January 8, 2011.
  11. "The best water flossers in 2023". edition.cnn.com. 26 October 2022. Retrieved 2023-02-15.
  12. Gorbunkova, A.; Pagni, G.; Brizhak, A.; Farronato, G.; Rasperini, G. (2016). "Impact of Orthodontic Treatment on Periodontal Tissues". International Journal of Dentistry. 2016. doi: 10.1155/2016/4723589 . PMC   4745353 . PMID   26904120.
  13. Felix, J. E.; Rosen, S.; App, G. R. (1971). "Detection of bacteremia after the use of an oral irrigation device in subjects with periodontitis". Journal of Periodontology. 42 (12): 785–787. doi:10.1902/jop.1971.42.12.785. PMID   4399159 . Retrieved 2023-02-15.
  14. Jahn, C. A. (2010). "The dental water jet: a historical review of the literature". Journal of Dental Hygiene. 84 (3): 114–120. PMID   20579423 . Retrieved 2023-02-15.