ORAL IRRIGATORS

a.k.a Water Floss

Is it just me or is it always so complicated to make someone understand how to floss! Use your middle finger to wrap it around and use your thumbs and index finger to maneuver it…….trust me….the person will loose his patience before figuring it out !! So there came a simple solution for people who are ‘busy’ (or lazy!) to use floss…….ORAL IRRIGATION DEVICES, also known as Water Floss or even Dental Water jets.

 

Stating the obvious, oral irrigators should not be considered as an alternative to brushing. It is effective in cleaning away food debris that can become stuck between teeth and aids in the prevention and treatment of plaque and forms of gum disease such as gingivitis.

A BRIEF HISTORY

It was WaterPik who first introduced these systems in 1966 as a plaque and debris removal device. But unfortunately at that time the researchers were not able to fully show its plaque removal capabilities. It was not accepted as a valuable part of plaque control.

But contrary to the attitude of the professionals, the patients found the systems effective and continued to use them. Surprisingly these patients always showed better than average oral health.

The irrigation research now focuses more on plaque alteration than removal. Alterations in sub-gingival plaque have been observed, along with changes in immune responses. Without plaque removal, irrigation seems to affect bacteria within the plaque, thickness of the plaque and immune response

HOW DO THEY WORK?

In simple words it uses a high pressured stream of water to remove food/debris from around the teeth.

A gentle penetrated stream of water targets and flushes away food debris. The use of water is vital to cleanliness as is its use of a magnetized mechanism which attacks and picks up food particles to effectively clean and refresh your teeth.

Some oral irrigators have a magnetic component which changes the polarity of water reducing calculus depositions. Others are controlled by hand pumping rather than electricity. Full mouth irrigation devices are also being developed with the idea of reaching all areas effectively and saving time.

Oral irrigators aim to treat the following conditions:

1. Gum disease
2.  Periodontal issues
3.  Those with dental appliances like braces
4. Plaque and tartar
5. Bad breath
6. Tooth decay

 IRRIGATION VS RINSING

·        Best anti-plaque agent available right now is Chlorhexidine. But rinsing does not reach sub-gingival or interproximal areas.

·        Oral irrigation with water was more effective in controlling gingivitis than rinsing with chlorhexidine

·        Chlorhexidine should be saved for patients with non-responding areas. Water is the first choice for rest.

TYPES/MODELS AVAILABLE

Different brands have their own specifications, the most popular ones being those offered by Waterpik, the Hydro floss and Kitty Hydro Care. The different models available are:

§  Hand-held Oral Irrigator – 

o   Target hard to reach areas in the mouth.                                                               

o   Offers an exemplary level of flexibility.                                                                           

o   Have pulsations of 1200 though there are some that are more powerful.                                                                                                                                      

o   Beneficial to those with dental appliances like braces for ease of use.

§  Counter-top Oral Irrigators –

o   As effective in the cleaning of teeth as the hand-held appliance but is a larger unit.                                                                                                                     

o   Come with various detachable attachments.                                                             

o   Tend to take up more space.

§  Cordless Oral Irrigators – 

o   Do not need to be centered on any counter to work as they offer a great level of flexibility

o   They are rechargeable.

o   Makes it simple to clean your teeth and is an excellent substitute to dental floss.

o   Include water jet air that comfortably massages the gums and removes bacteria.

o   Comfortable and easy to hold as well as offering a great level of portability.

ADVANTAGES

We already have a fair idea of why these systems are beneficial. Here are a few more pointers:

 Ø Better patient compliance. Only 30% of patients perform adequate home care with brushes and some sort of interproximal aid. 35% of patients occasionally use dental floss and only 2-15% floss daily.

Ø Decreased tooth and gum sensitivity

Ø Removes food and bacteria stuck in between teeth and under the gums which lead to decay and periodontal disease.

Ø Better penetration compared to flossing/brushing/rinsing. Alterations of sub-gingival plaque have been measured both qualitatively and quantitatively as deep as 6 millimeters.

Ø Reductions in bleeding upon probing, pocket depths and inflammatory cytokines, interleukin 1 (IL-1) and prostaglandin (PG-E2) were observed

Ø Supra-gingival irrigation controls bacterial levels before they can influence sub-gingival areas, since reduction of supra-gingival plaque

Ø Patients who wear dental appliances such as braces or bridges will find an oral irrigator to be the perfect solution to maintaining oral health.

Ø Better oral hygiene can be achieved by individuals with special needs.

Ø Less frequent trips to the dentist, less money spent while you are there (can be seen as a disadvantage too!).

DISADVANTAGES

Ø As expected the systems would take out more from your pockets than your standard floss. Also the tips need to be changed frequently. 

Ø As unlikely as it may sound, these is a danger of electrocution if not used carefully in the bathrooms.

Ø Studies have shown no added benefit of irrigation following Sub-gingival Debridement and/or Root Planning

Ø As per the ADA there are chances of bacteria coming into your bloodstream with the use of oral irrigators.

Ø The oral irrigator should not be used if you have tooth absences, severe periodontitis, or a ‘predisposition’ to bacterial infections.

Ø High settings could push debris into the tissue, rather than pushing it out, as intended.

COST AND BRANDS IN MARKET

The cost varies from brand to brand and also the type of system one opts for. Also there is an additional cost for different tips that one chooses to buy. There are various brands in the market. Some of the known ones are:

    Waterpik

·        By far the most known brand

·        Offers a wide range of products

·        Anywhere from $15-80 (1000-4000)

·        http://www.waterpik.com/oral-health/why-waterpik.html 

    Oral B

·        Offers a variety of products

·        Approximately $95-100 (Rs.4500-5000) http://www.oralbprofessional.com/us/products/power/pow7900.asp

    Hydro Care

Approximately $30-40 (Rs.1500-2000)

    Kitty Hydro Floss

Approximately $90-100 (Rs.4500-5000)

    Panasonic

Approximately $50-60 (Rs.2500-3000)

Maintaining good oral hygiene is vital in promoting healthy teeth and gums; brushing is also an essential part in warding off unwanted oral health conditions. Oral irrigators can be included in your oral hygiene routine to effectively combat plaque and are simple to use.