The Role of Interdental Cleaning for Oral Health, General Health and Quality of Life

Oral health is multi-faceted and includes the ability to speak, smile, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease of the craniofacial complex, according to the definition from the World Dental Federation, FDI (Glick et al. 2016). With this definition in mind, oral health is an undeniable part of general health and wellbeing.

Periodontal disease is common worldwide. It affects approximately 50% of the adult population, and severe periodontitis prevalence varies from 10 to 15%; prevalence figures are positively associated with increasing age (Chapple et al. 2015, Petersen and Ogawa 2012, Eke et al. 2015). Given the massive effects of the disease, it becomes clear that it should be a matter of global concern.

First, there is growing scientific support for a link between periodontal disease and several general diseases, e.g., cardiovascular disease, diabetes, and obesity. Thus, oral diseases are no longer considered as local problems affecting the oral cavity but rather diseases with consequences for overall health (Holmstrup et al. 2017).

Research has also shown a significant association between periodontal disease and oral health-related quality of life – independent of factors like age, gender and other dental problems (Masood et al. 2019). The disease can contribute to anxiety, low self-esteem, and feelings of shame and vulnerability (Herrera et al.).

Oral diseases also have a vast impact from a financial perspective. In 2015, on a global basis, the total cost was shown to be $544.41 billion, where direct costs, measured as dental expenditures costs, accounted for $356.80 billion, and indirect costs, measured as productivity losses, were $187.61 billion. Among oral diseases, periodontitis was the second biggest cause for global productivity costs (Righolt et al. 2018). Severe periodontitis accounts for $54 billion yearly due to indirect costs (Listl et al. 2015).

Dental professionals have a central role in preventing disease through a health-promoting approach based on science and proven clinical experience. Evaluating individual needs and conditions and weighing them together with scientific support should form the basis for instructions and recommendations, thus creating the best possible foundation for patient compliance and long-lasting oral health.

There are several risk factors for the development of periodontitis. Most important is the accumulation of a plaque biofilm along and below the gingival margin. Control and removal of this biofilm are of utmost importance to maintain oral health. The significance of good oral hygiene in order to prevent oral disease is, therefore, indisputable.

Toothbrushing and interdental cleaning are cornerstones to achieve high-quality oral hygiene. Interdental cleaning is associated with lower levels of periodontal disease, and periodontal health increases with a higher frequency of use of interdental cleaning devices (Marchesan et al. 2018). The recommendation of an interdental cleaning device needs to be tailored, but for the majority of the grown-up population, an interdental brush is preferred.

Current research emphasizes the importance of good oral hygiene in maintaining oral health and its consequences for general health and quality of life. Because the most common oral diseases are predominantly interdental diseases, preventive efforts must include interdental cleaning as an adjunct to toothbrushing in daily home care. In achieving optimal plaque control, the interdental brush is the preferred device for most of the adult population globally.

A preventive approach is well in line with the global goals for oral health 2020 from FDI, where one of the targets is to increase the population of people in all ages with healthy periodontium (Hobdell et al. 2003). FDI also has a vision for 2020 of ensuring that oral health is recognized and accepted as a core element of general health and wellbeing (Glick et al. 2012). In light of the financial reports, a preventive approach is most likely beneficial also from an economic perspective, since it will limit the need for other dental treatments.