Beyond the brush: Long-term study finds interdental cleaners may help prevent tooth loss
29 July 2025
- Study examined five years of dental health check-up data
- Dental flossing was more beneficial in healthy individuals
- Interdental brushes were more effective in individuals with periodontitis
A comprehensive joint study analyzing the link between interdental cleaning devices and tooth loss over five years indicates that longer-term use of interdental tools may help prevent tooth loss, while the effectiveness of different tools also depends on periodontal health.
The joint research by Jichi Medical University, Japan, and international oral healthcare company, Sunstar, examined five years of dental health check-up data from 845 Sunstar employees. While previous short-term clinical trials have demonstrated the effectiveness of interdental cleaning devices in preventing periodontal disease and caries, long-term evidence has been limited.
The study found that individuals with healthy gums (no periodontal pockets), who used dental floss for 4-5 years had a lower risk of tooth loss compared to those with under a year of usage. Similarly, in patients with periodontal disease (presence of periodontal pockets), individuals who had used interdental brushes for 4–5 years experienced a lower risk of tooth loss than those who had used for less than a year.
Tooth loss is associated with increased risk of systemic diseases and a decline in quality of life. The research published in BMC Oral Health suggests that preventing tooth loss through proper oral care is crucial. Specifically, the study implies that long-term use of interdental cleaning devices, personalized to individual oral conditions, may play a vital role in maintaining oral health.
Analyzing dental health data from 845 Sunstar employees (average age: 47.8) who received annual dental checkups from 2012 to 2017, the research focused on the type and duration of interdental cleaning device use (dental floss or interdental brush; categorized as 0-1 year, 2-3 years, or 4-5 years).
The presence or absence of tooth loss among participants was classified into two groups based on their CPI (Community Periodontal Index) scores from a 2012 checkup: the healthy group, with no periodontal pockets (CPI < 3), and the periodontitis group, with a presence of periodontal pockets (CPI ≥ 3).
The association between interdental cleaning device use and tooth loss was analyzed separately for each group using a logistic regression model, adjusting for age, gender, dental caries experience (DMFT index), smoking status, years of dental visits, and brushing frequency.
Compared to the healthy group (645 people), the periodontitis group (200 people) had fewer women, was older, and had higher DMFT scores and more years of dental visits. Among the healthy group, long-term dental floss users were more common, while the periodontitis group had a higher proportion of long-term interdental brush users.
In the healthy group, participants who used dental floss for 4-5 years had an odds ratio of 0.42 for tooth loss, compared to those who used it for less than a year. In the periodontitis group, those who used interdental brushes for 4-5 years had an odds ratio of 0.38 for tooth loss compared to those with under a year of use.
The results indicate a significantly lower tooth loss risk with long-term use of appropriate interdental cleaning tools and highlight the importance of continuous use of interdental cleaning devices in preventing tooth loss. Dental floss was more effective in the healthy group, while interdental brushes were more effective in those with periodontal disease, demonstrating that choosing the right tool based on an individual’s periodontal condition is crucial.
This longer-term study complements the findings of previous shorter-term studies and provides strong evidence on the importance of interdental cleaning as part of daily oral hygiene routines. Future research by the Department of Community and Family Medicine, Jichi Medical University and Sunstar using even larger datasets is expected to help establish more personalized and effective oral care guidance that can be offered as part of routine dental check-ups.
Publication Information: The importance of using interdental cleaning devices on prevention of tooth loss in an employee population: a cross-sectional study. Authors: Kyoko Nakao, Miki Ishikawa, Takako Yasuda, Yuji Furui, Kazuhiko Kotani Journal: BMC Oral Health. DOI: https://doi.org/10.1186/s12903-024-05308- 0