Oral irrigator

Dental care device

An oral irrigator

An oral irrigator (also called a dental water jet, water flosser or, by the brand name of the best-known such device, Waterpik) is a home dental care device which uses a stream of high-pressure pulsating water intended to remove dental plaque and food debris between teeth and below the gum line. Regular use of an oral irrigator is believed to improve gingival health. The devices may also provide easier cleaning for braces and dental implants.[1] However, more research is needed to confirm plaque biofilm removal and effectiveness when used by patients with special oral or systemic health needs.[2]

## History

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The first oral irrigator was developed in the 1950s by Dr. C.D. Matteson, who patented the invention in 1955.[3] Dr. Matteson's invention was designed to cleanse the teeth and gums after meals as an alternative to using hand syringes. It attached directly to a sink's faucet and featured a mechanical valve to control water pressure.[4]

Later, in 1962, dentist Gerald Moyer and engineer John Mattingly invented Waterpik. The Waterpik featured a built in reservoir and motor to pump water out of a tip at rhythmic pulses.[5] The Waterpik is now sold by Water Pik, Inc.[6]

## Efficacy

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Oral irrigators have been evaluated in a number of scientific studies and have been tested for periodontal maintenance,[7] and those with gingivitis, diabetes, orthodontic appliances, and tooth replacements such as crowns, and implants.[2]

A 2008 systematic review found improvement in gingival health with irrigation compared with regular oral hygiene, although there was no reduction in plaque.[8] A 2019 meta-analysis found that water-jet irrigation is more effective at reducing bleeding on probing than flossing.[9]

## Other uses

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Oral irrigators have also been used to remove tonsil stones ("tonsiloliths") in those subject to them.[10]

## Mode of operation

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Most oral irrigators use a single stream of water to flush unwanted material from between the teeth. Compared to flossing, oral irrigators are also ideal for narrow teeth or hard-to-reach areas between teeth.

The market also offers devices in which it is possible to specifically massage the gums using sophisticated massage heads. In addition, mouthwash solution can be injected into periodontal pockets using the sub-gingival nozzle, used as a nozzle.

## Cleaning technique

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After filling the reservoir with water, point the nozzle close to the gum line at an angle of 90 degrees.[11] Then start the device by setting the appropriate pressure value. It is recommended to start irrigation from the back teeth, slowly following the gum line. The water jet should be directed between the tooth spaces, surfaces above the gum line, stopping momentarily at the area to be cleaned. In the case of hard-to-reach areas such as when using braces, in gum pockets, the angle of the nozzle can be changed.[12]

## Criticism

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Dentists classify the oral irrigator as a wellness product, because it cannot replace medically sensible brushing and flossing. There is only a possible improvement in blood circulation in the gums due to the massage effect. On the other hand, there is a risk that food debris will get into the tooth pockets due to improper use ("flushing the tooth pockets") and damage the teeth and gums there. Because of this risk, most dentists do not recommend the use of oral irrigators.[13] Many dentists advise against usage of an irrigator for people with gum disease or have had a tooth extraction.

However, other studies have shown that oral irrigators are better at removing plaque than flossing.[14]

## See also

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Wikimedia Commons has media related to Oral irrigator.

* Dental floss

## References

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1. ^ Ng, Ethan; Lim, Lum Peng (2019-06-01). "An Overview of Different Interdental Cleaning Aids and Their Effectiveness". Dentistry Journal. 7 (2): 6. Oral Irrigators. doi:10.3390/dj7020056. ISSN 2304-6767. PMC 6630384. PMID 31159354.
2. ^ a b Jahn, Carol A. (2010). "The dental water jet: a historical review of the literature". Journal of Dental Hygiene. 84 (3): 114–120. ISSN 1553-0205. PMID 20579423.
3. ^ "The Complete History of Oral Irrigation (Water Flossing) | Instafloss". 10 August 2021.
4. ^ US 2829645, Matteson, Clarence D., "Hydraulic dental syringe", issued 1958-04-08
5. ^ Dulken, Stephen van (2004). American Inventions: A History of Curious, Extraordinary, and Just Plain Useful Patents. NYU Press. pp. 98, 99. ISBN 978-0-8147-8813-4.
6. ^ "About Water Pik, Inc". Water Pik, Inc.
7. ^ Sharma, N; Lyle, D; Qaqish, J; Galustians, J; Schuller, R (2008). "Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances". American Journal of Orthodontics and Dentofacial Orthopedics. 133 (4): 565–71, quiz 628.e1–2. doi:10.1016/j.ajodo.2007.12.008. PMID 18405821.
8. ^ Husseini, A.; Slot, D. E.; Weijden, GA Van der (2008). "The efficacy of oral irrigation in addition to a toothbrush on plaque and the clinical parameters of periodontal inflammation: a systematic review". International Journal of Dental Hygiene. 6 (4). Centre for Reviews and Dissemination (UK): 304–314. doi:10.1111/j.1601-5037.2008.00343.x. PMID 19138181.
9. ^ Kotsakis, Georgios A.; Lian, Qinshu; Ioannou, Andreas L.; Michalowicz, Bryan S.; John, Mike; Chu, Haitao (May 2018). "A Network Meta-analysis of Interproximal Oral Hygiene Methods in the Reduction of Clinical Indices of Inflammation". Journal of Periodontology. 89 (5): 558–570. doi:10.1002/JPER.17-0368. ISSN 0022-3492. PMC 5984142. PMID 29520910. "The second greatest additional reduction in BOP against control was noted for waterjet (WJ) ... Floss (FL) and automated floss (FL2) were also significantly more effective than control in reducing BOP, but the effect size was relatively small for both interventions"
10. ^ Svoboda, Elizabeth (August 31, 2009). "In Tonsils, a Problem the Size of a Pea". The New York Times. Retrieved January 8, 2011.
11. ^ "The best water flossers in 2023". edition.cnn.com. 26 October 2022. Retrieved 2023-02-15.
12. ^ Gorbunkova, A.; Pagni, G.; Brizhak, A.; Farronato, G.; Rasperini, G. (2016). "Impact of Orthodontic Treatment on Periodontal Tissues". International Journal of Dentistry. 2016. doi:10.1155/2016/4723589. PMC 4745353. PMID 26904120.
13. ^ Felix, J. E.; Rosen, S.; App, G. R. (1971). "Detection of bacteremia after the use of an oral irrigation device in subjects with periodontitis". Journal of Periodontology. 42 (12): 785–787. doi:10.1902/jop.1971.42.12.785. PMID 4399159. Retrieved 2023-02-15.
14. ^ Jahn, C. A. (2010). "The dental water jet: a historical review of the literature". Journal of Dental Hygiene. 84 (3): 114–120. PMID 20579423. Retrieved 2023-02-15.

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