The Effectiveness of Brushing and Flossing Sequence on Control of Plaque and Gingival Inflammation
Condition: Gingival Inflammation; Plaque; Gingival Bleeding; Plaque Control
MeSH terms: Gingivitis; Gingival Hemorrhage; Inflammation; Hemorrhage
Study type: Interventional

Summary: 
      This study evaluates the effectiveness of brushing and flossing sequence in the control of
      dental plaque and gingival inflammation.
    

Detailed description: 
      Periodontal disease is the disease of the supporting dental tissues like alveolar
      bone,periodontal ligament cementum and gingiva. The most common form is plaque-induced
      gingivitis . Bleeding on gingival probing is one of the hallmarks of gingival
      inflammation.The removal of dental plaque is the most crucial action for preventing and
      treating gingival inflammation. Toothbrush along with toothpaste are still the most reliable
      means of plaque control. However, cleaning should be thorough and performed at regular
      intervals.

      Toothbrush has a limited ability to reach all the areas around the tooth. Inter-dental areas
      are prone for plaque accumulation and gingival inflammation. Dental floss is one of the most
      effective tool in addition to tooth brush to remove inter-dental plaque. The sequence of
      using toothbrush and dental floss may influence the removal of dental plaque and consequently
      reducing the bleeding on probing of gingiva. There is conflicting evidence in the literature.
      The hypothesis of this study is that the sequence of brushing and flossing will not influence
      control of plaque control and gingival inflammation.
    

Intervention name(s): Brushing first and Flossing later (BF); Flossing first and Brushing later (FB)
Intervention type(s): Other; Other
Intervention description(s): Participants will follow Brushing first and flossing later (BF) sequence for 2 weeks, and after 1 week wash out period, Flossing first and Brushing later (FB) sequence for another 2 weeks.; Participants will follow Flossing first and Brushing later (FB) sequence for 2 weeks, and after 1 week wash out period, Brushing first and flossing later (BF) sequence for another 2 weeks.
Other intervention name(s): Colgate® tooth brush and Colgate® Dental Floss; Colgate® tooth brush and Colgate® Dental Floss
Intervention MeSH terms: Listerine; Sodium Fluoride
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: Participants will be selected by random sampling and allocated to Two Arms: Arm-I - Brushing first and Flossing later (BF), Arm II- Flossing first and brushing later (FB) after applying inclusion and exclusion criteria.
The participants in BF group will Brush first using Colgate® tooth brush for a 2-week period. and then floss with Colgate® dental floss using Spool method for a 2-week period. This is followed by a one week wash out period After this cross over is done in which participants will change the sequence to FB wherein they will floss first and brush later.
The participants in FB group will floss first with Colgate® dental floss and brush later using Colgate® tooth brush for a 2-week period. This is followed by a one week wash out period. After this cross over is done in which participants will change the sequence to BF wherein they will Brush first and Floss later.
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Gingiva; Gingivitis; Flossing; Brushing; Plaque control; Gingival bleeding; Bleeding point index; Rustogi Modified Navy Plaque Index; Dental Plaque; Tooth brushing