Seniors and Boomers: Living Longer, Living Healthier ... - Waterpik

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Xerostomia can cause both clinical and functional oral health problems. As the mouth dries, plaque increases and this may lead to an increase in caries, particularly root surface decay. The saliva glands may become enlarged. It may be difficult to wear a denture. Functionally, severe xerostomia can make it difficult to chew, swallow, or even talk. 45 There are numerous over-the-counter products to help relieve xerostomia. These include oral rinses, gels, sprays, and artificial saliva. For more severe cases, prescription medications are available. It is common for people suffering from xerostomia to use gum, mints or lozenges that often contain sugar. This increases the risk for decay. Patients should be advised to only use sugar-free, non-acidic products. Chewing gum containing xylitol may be an option. Depending upon oral health status, supplemental fluoride treatments may be required. 45 ORAL HEALTH INTERVENTIONS Chronic health problems and disabilities can make daily care a challenge for many older individuals. Individuals with arthritis may not be able to use floss or any type of product that requires expert manual dexterity. Power toothbrushes are an ideal brushing choice for those who have difficulty with home care devices. Handles tend to be larger than on manual brushes making them easier to grip. The mechanized action of the brush head allows the patient to focus only on placement thus reducing one of the variables associated with poor brushing. A power toothbrush may also be a good tool for a caregiver. Most seniors need some type of interdental cleaning. Dental floss has long been the primary self-care recommendation made by most dental professionals. However, dental floss may not be the best product choice for older individuals because the dexterity required to use the product effectively may not be present. The Waterpik ® Water Flosser (Figure 5) is clinically proven to be an easier, more effective alternative to string floss. Three studies with three types of tips have compared the Water Flosser to string floss. In each study, the Water Flosser provided superior results over string floss for reducing gingival bleeding (Figures 6 and 7). 47,48,49 The Orthodontic Tip (Figure 8) was three times more effective at removing plaque than string floss and five time more effective than brushing alone on adolescents with fixed orthodontic appliances (Figure 9). 48 There were no significant differences in plaque biofilm removal between the Classic Jet Tip (Figure 10), Plaque Seeker ® Tip (Figure 11) and string floss. 47,49 Figure 4: Reduction of approximal plaque 46 Figure 5: Waterpik ® Ultra Water Flosser, Model WP-100W Sonic toothbrushes are popular power toothbrushes (Figure 1). One study found the Waterpik ® Sensonic ® Professional Toothbrush (Water Pik, Inc., Fort Collins, CO) was significantly more effective than the Sonicare ® FlexCare, (Philips Oral Healthcare, Snolqualmie, WA) in removing plaque (29%) and reducing bleeding (26%) and gingivitis (20%) 46 (Figures 2, 3 and 4). Figure 1: Waterpik ® Sensonic ® Professional Plus Toothbrush—Model SR-3000W Figure 6: Reduction of gingival bleeding compared to string floss 47 Figure 7: Reduction of gingival bleeding at 14 days 49 Figure 2: Reduction of whole mouth plaque 46 Figure 3: Reduction of marginal plaque 46 Figure 8: Orthodontic Tip Figure 9: Reduction of plaque versus string floss 48 8
Figure 10: Classic Jet Tip Figure 11: Plaque Seeker ® Tip The Waterpik ® Water Flosser has been compared to an air-driven device that delivered a teaspoon of water under pressurized air (Sonicare ® Air Floss) in a four-week randomized clinical trial (RCT). The result showed that the Water Flosser was 80% more effective at reducing gingivitis (Figure 12) and 70% more effective at reducing plaque biofilm (Figure 13). Specifically, the Water Flosser was twice as effective from the lingual surface and three times as effective at the gingival margin as Air Floss in removing plaque. 50 % Reduction 60 45 30 15 0 Air Floss 80 % MORE EFFECTIVE* Gingivitis Reduction Water Flosser 65 % MORE EFFECTIVE* 101 % 43.9 41.2 % MORE EFFECTIVE* % 39.4 % 26.6 % 22.8 % 19.1 % Whole Mouth Facial Lingual *Statistically significant difference Figure 12: Water Flosser versus Air Floss; gingivitis reductions % Reduction 100 80 60 40 20 0 Air Floss Figure 14: Waterpik ® Complete Care, Model WP-900W Figure 15: Complete Care versus Sonicare ® FlexCare or a manual toothbrush; bleeding reductions A study at the University of Southern California Center for Biofilms was conducted to determine the plaque biofilm removal capabilities of the Water Flosser. The investigators evaluated the effect of a three-second pulsating (1,200 pulses per minute) lavage at medium pressure Plaque Reduction on plaque biofilm using scanning electron microscopy Water (SEM). Flosser The results showed that the Water Flosser with the Classic 60 Jet % Tip removed 99.9% of plaque biofilm from treated areas (Figures 16 and 17). The researchers concluded that the hydraulic forces produced 47 by % MORE EFFECTIVE* the 106 Water % Flosser with 1,200 pulsations at MORE EFFECTIVE* medium pressure can significantly 49.0 remove plaque biofilm from % treated 233 areas % 35.9 of tooth surfaces. 51 % MORE EFFECTIVE* 76.7 % 70 % MORE EFFECTIVE* 50.9 52.8 % % 48.0 % 30.0 % MORE EFFECTIVE* 25.0 % 7.5 % 23.8 % Whole Mouth Approximal Marginal Facial Lingual *Statistically significant difference tion ce 101 % MORE EFFECTIVE* 19.1 % Lingual 39.4 % % Reduction 100 80 60 40 20 0 Air Floss Water Flosser 60 % MORE EFFECTIVE* Plaque Reduction 76.7 % 70 % 47 % MORE EFFECTIVE* 106 MORE EFFECTIVE* MORE EFFECTIVE* 50.9 % 7.5 % 233 % 35.9 % MORE EFFECTIVE* 25.0 % 23.8 % Whole Mouth Approximal Marginal Facial Lingual *Statistically significant difference Figure 13: Water Flosser versus Air Floss; plaque reductions Using both a sonic toothbrush and a Water Flosser can provide additional benefits over using either a sonic toothbrush or manual toothbrush alone. A 4-week study with 140 subjects found that individuals who used a combination device (Waterpik ® Complete Care, Figure 14) of a Water Flosser and Waterpik ® Sensonic ® Professional Plus Toothbrush had a 70% better reduction in bleeding and 52% better reduction in plaque removal versus those who used the Sonicare ® FlexCare only. In comparison to manual toothbrush, the Complete Care regimen was 159% better at reducing bleeding and 134% better at plaque removal 46 (Figure 15). Figure 16: Before treatment with the Water Flosser 51 In addition to difficulty with string floss, seniors may have other cleaning challenges. The Water Flosser has been shown to benefit people with unique and/or general health conditions including: • Orthodontic appliances 48 • Implants 52 • Crowns and/or bridges 53 • Diabetes 54 Conclusion Figure 17: Tooth surface after threesecond use with Water Flosser 51 Baby boomers and seniors will experience improved health and greater longevity than previous generations. Yet, many will live with chronic disease or disabilities that can impair their mobility and social functioning. The need for oral care will continue. Dental professionals will be called upon to help older individuals find new pathways to care and continue to dispense oral hygiene advice. 9
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Seniors and Boomers: Living Longer, Living Healthier ... - Waterpik

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