This review of the efficacy of interdental cleaning devices (ICDs) used with active substances, as adjuncts to toothbrushing included 7 RCTs. However, none of the available studies was at low risk of bias and all were small. While the findings suggest s benefit from using ICDs with active substances the evidence is of very low certainty so additional high qiality well reported trials are needed.
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This review comparing the clinical performance of flossing before or after toothbrushing included two small RCTs involving a total of 60 patients. The findings suggest no difference with the use of floss before or after toothbrushing however the quality of the evidence is limited.
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This review of the efficacy of rubber bristles interdental cleaners (RBIC) as an adjunct to toothbrushing (TB) included 6 RCTs. The findings provide weak to very weak certainty evidence for the use of RBICs for gingivitis and plaque reduction.
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