Comparative Efficacy of Dental Flossing Before or After Tooth Brushing on Interproximal Plaque Reduction and Fluoride Retention in That Area

Study Overview
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Brief Summary
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This randomized controlled crossover trial conducted on 25 dental students. in the preliminary session each volunteer was given a toothbrush(Trisa, soft, Switzerland) and toothpaste(Pooneh, Iran) and Dental Floss( Mina, Iran)to use during the study, and they were instructed the proper techniques of brushing and flossing.The study was performed in two treatment sessions and a 48 hour washout period. They passed through the sessions in a randomized sequence. After prophylaxis with rubber cup, they were asked to discontinue all oral hygiene for 24 hour. At the first session , they flossed first followed by brushing (floss-brush group) and at the other session they used dental floss after brushing (brush-floss group) . At each session, before and after brushing and flossing , Dental plaque reduction was assessed using Rustogi Modified Navi Plaque Index. Interdental plaque was collected for measuring fluoride. Differences between the two groups were analyzed with mixed model test.

Conditions
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Dental Devices, Home Care

Intervention / Treatment
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* Behavioral: Flossing before Brushing
* Behavioral: Brushing before Flossing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Dental students with 16 teeth in each jaw who had Normal salivary volume No active caries No medicine which could be affect salivary secretion No fluoride consumption in the last two weeks No Antibiotic consumption in the last 4 weeks Exclusion Criteria: Any systemic diseases Periodontal diseases Crowding

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Floss-Brush group<br>The participants flossed first followed by brushing | Behavioral: Flossing before Brushing<br> <br> |
| Active Comparator: Brush-Floss group<br>They used dental floss after brushing | Behavioral: Brushing before Flossing<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dental plaque reduction | Dental plaque assessed using a scale known as: Rustogi Modified Navy Plaque Index | immediately Before brushing/ flossing and immediately after these procedures | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fluoride concentration in Interdental plaque | fluoride concentration measured using ppm scale (microgram/milliliter) | Immediately after toothbrushing /flossing interdental plaque was collected for fluoride measurement |