By Investigating the impact of water flossing on gingival inflammation and supragingival plaque microbiota through a 12-week randomized controlled trial

Received: 21 November 2022 / Accepted: 19 May 2023
© The Author(s) 2023

Introduction

The periodontal diseases are highly prevalent and can afect up to 90% of the worldwide population [1]. Gingivitis is the most prevalent form of periodontal disease. According to the released data from the fourth national oral health epidemiology survey of China, the prevalence of gingival bleeding is over 87.4% in middle-aged and elderly people in China [2]. Gingivitis is typically caused by dental plaque accumulation. Streptococcus, Fusobacterium, Actinomyces, Veillonella, and Treponema, and possibly Bacteroides, Capnocytophaga, and Eikenella, are etiologically involved [3]. Microbialcolonization and participation is sequential, with the complexity of the associated fora increasing with time [3]. Other local or systemic etiologic factors such asdefective prosthesis, smoking, and hormones may also promote plaque deposition and/or predispose the host tomicrobial attack [4]. The ecological balance via both intermicrobial and host-microbial interactions plays a critical rolein maintaining the gingival tissue health [5]. Disruption of this homeostatic balance leads to selective outgrowth of species with potential for destructive infammation, and increases in the bacterial burden promote gingival infammation in this condition [5, 6]. Gingivitis is a key risk factor of periodontitis, and control of gingival infammation is crucial for the primary prevention of periodontitis [7]. In addition, halitosis, which shares risk factors with periodontal diseases, is also common among patients with gingivitis or periodontitis [8].