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Background: The purpose of this study was to assess the effects of dental flossing on the microbial composition of interproximal plaque samples in matched twins. Methods: The study was a two-treatment, examiner-masked, randomized, parallel-group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2-week supervised and unsupervised treatment regimen consisting of tongue brushing and toothbrushing or tongue brushing and toothbrushing plus flossing. The reversecapture checkerboard hybridization assay was used to assess levels (abundance) of 26 microbial species in interproximal plaque samples collected from six sites per subject. An integrative computational predictive model estimated average changes in microbial abundance patterns of selected bacterial species from baseline to 2 weeks by comparing treatment groups. Results: After the 2-week study period, putative periodontal pathogens and cariogenic bacteria were overabundant in the group that did not floss compared to the group that performed flossing. Those included Treponema denticola, Porphyromonas gingivalis, Tannerella torsythia (previously T. forsythensis), Prevotella intermedia, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Streptococcus mutans. Microbial species that are not consistent with the development of periodontal disease or dental caries were overabundant in the group that did floss compared to the non-flossing group. Conclusion: In a well-matched twin cohort, tooth and tongue brushing plus flossing significantly decreased the abundance of microbial species associated with periodontal disease and dental caries after a 2-week program. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to assess treatment responses to dental flossing in twins. Methods: The study was a two treatment, examiner-blind, randomized, parallel group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2 week supervised and unsupervised treatment regimen consisting of 1) tongue brushing and toothbrushing (TB) and 2) TB + flossing (TB+FI). Clinical endpoints were gingival bleeding (papillary bleeding score [PBS]) and oral malodor (levels of volatile sulfur compounds [VSC]). Analysis of variance and covariance methodologies were employed to analyze the data. Results: Baseline average PBS values were 1.352 and 1.342 for the TB+FI and TB groups, respectively (P=0.937). After 2 weeks of treatment, the TB+FI group had a statistically significant decrease in PBS values of 0.558 (41.5% versus baseline), whereas the TB group showed no improvement from baseline. The change from baseline for the TB+FI group was superior to that for the TB group (P<0.001). Similar findings were observed for the number of baseline papillary bleeding sites. Baseline average intraoral halimeter values were 45.91 and 41.75 for the TB+FI and TB groups, respectively (P = 0.504). Both treatment regimens demonstrated highly statistically significant reductions in intraoral breath values versus baseline (all P <0.00]), and the difference between treatment groups was not statistically significant (P = 0.339). Similar findings were found for expired air. Conclusions: In a well-matched twin cohort, tongue and toothbrushing plus flossing significantly decreased gingival bleeding after 2 weeks. [ABSTRACT FROM AUTHOR]