{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:12:27Z","timestamp":1793293947184,"version":"4.5.0"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"clinical research projects of the State Institute of Drug\/Medical Device Clinical Trial, West China Hospital of Stomatology, Sichuan University","award":["QX2020-02-01, QX2020-02-02"],"award-info":[{"award-number":["QX2020-02-01, QX2020-02-02"]}]},{"name":"the research fund from the West China School\/Hospital of Stomatology, Sichuan University","award":["LCYJ2019-4, RCDWJS2021-16"],"award-info":[{"award-number":["LCYJ2019-4, RCDWJS2021-16"]}]},{"name":"the research fund from the West China School\/Hospital of Stomatology, Sichuan University","award":["LCYJ2019-4, RCDWJS2021-16"],"award-info":[{"award-number":["LCYJ2019-4, RCDWJS2021-16"]}]},{"name":"the Technology Innovation Research and Development project of Chengdu","award":["2021-YF05-01866-SN"],"award-info":[{"award-number":["2021-YF05-01866-SN"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Objectives\n<\/jats:title>\n                <jats:p>The effects of water flossing on dental plaque removal have been suggested, but its ecological impact on dental plaque microbiota needs further investigation. In addition, whether this plaque control measure by water flossing promotes the control of halitosis still needs clinical validation. The aim of this study was to evaluate the effects of water flossing on gingival inflammation and supragingival plaque microbiota.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Seventy participants with gingivitis were randomly assigned to control (toothbrushing) and experimental (toothbrushing\u2009+\u2009water flossing) groups (<jats:italic>n<\/jats:italic>\u2009=\u200935). Participants were recalled at 4, 8, and 12\u00a0weeks, and their gingival index, sulcus bleeding index, bleeding on probing, dental plaque index, and oral malodor values were measured. The microbiota of supragingival plaque was further investigated using 16S rRNA sequencing and qPCR.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Sixty-three participants completed all revisits (control: <jats:italic>n<\/jats:italic>\u2009=\u200933; experimental: <jats:italic>n<\/jats:italic>\u2009=\u200930). The experimental and control groups exhibited similar clinical characteristics and dental plaque microbiota at baseline. Adjunctive water flossing effectively reduced the gingival index and sulcus bleeding index as compared to the toothbrushing control group. The water-flossing group showed reduced oral malodor at week 12 as compared to the baseline. Consistently, the water-flossing group exhibited altered dental plaque microbiota at week 12, characterized by a depletion of <jats:italic>Prevotella<\/jats:italic> at genus level and <jats:italic>Prevotella intermedia<\/jats:italic> at species level as compared to the toothbrushing control. In addition, the plaque microbiota of water-flossing group exhibited a more aerobic phenotype, while the control group was more anaerobic.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Daily water flossing can effectively alleviate gingival inflammation and reduce oral malodor, possibly by depleting oral anaerobes and altering the oral microbiota to a more aerobic phenotype.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance<\/jats:title>\n                <jats:p>Water flossing adjunctive to toothbrushing effectively alleviated gingival inflammation, representing a promising oral hygiene practice to promote oral health.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical trial registration\n<\/jats:title>\n                <jats:p>The trial was registered in the Chinese Clinical Trial Registry (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\/showprojen.aspx?proj=61797\">http:\/\/www.chictr.org.cn\/showprojen.aspx?proj=61797<\/jats:ext-link>, #ChiCTR2000038508) on September 23, 2020.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00784-023-05081-4","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T20:30:47Z","timestamp":1685046647000},"page":"4567-4577","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Effects of water flossing on gingival inflammation and supragingival plaque microbiota: a 12-week randomized controlled trial"],"prefix":"10.1007","volume":"27","author":[{"given":"Xin","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yishan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haolai","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingqun","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"issue":"9499","key":"5081_CR1","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.1016\/S0140-6736(05)67728-8","volume":"366","author":"BL Pihlstrom","year":"2005","unstructured":"Pihlstrom BL, Michalowicz BS, Johnson NW (2005) Periodontal diseases. Lancet 366(9499):1809\u20131820. https:\/\/doi.org\/10.1016\/S0140-6736(05)67728-8","journal-title":"Lancet"},{"issue":"1","key":"5081_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41368-017-0006-6","volume":"10","author":"X Zhou","year":"2018","unstructured":"Zhou X, Xu X, Li J, Hu D, Hu T, Yin W, Fan Y, Zhang X (2018) Oral health in China: from vision to action. Int J Oral Sci 10(1):1. https:\/\/doi.org\/10.1038\/s41368-017-0006-6","journal-title":"Int J Oral Sci"},{"issue":"5","key":"5081_CR3","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1111\/j.1600-051x.1986.tb01471.x","volume":"13","author":"RC Page","year":"1986","unstructured":"Page RC (1986) Gingivitis. J Clin Periodontol 13(5):345\u2013359. https:\/\/doi.org\/10.1111\/j.1600-051x.1986.tb01471.x","journal-title":"J Clin Periodontol"},{"issue":"Suppl 1","key":"5081_CR4","doi-asserted-by":"publisher","first-page":"S46","DOI":"10.1002\/JPER.17-0576","volume":"89","author":"L Trombelli","year":"2018","unstructured":"Trombelli L, Farina R, Silva CO, Tatakis DN (2018) Plaque-induced gingivitis: case definition and diagnostic considerations. J Periodontol 89(Suppl 1):S46\u2013S73. https:\/\/doi.org\/10.1002\/JPER.17-0576","journal-title":"J Periodontol"},{"issue":"1","key":"5081_CR5","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/prd.12371","volume":"86","author":"G Hajishengallis","year":"2000","unstructured":"Hajishengallis G, Lamont RJ (2000) Polymicrobial communities in periodontal disease: their quasi-organismal nature and dialogue with the host. Periodontol 86(1):210\u2013230. https:\/\/doi.org\/10.1111\/prd.12371","journal-title":"Periodontol"},{"issue":"27","key":"5081_CR6","doi-asserted-by":"publisher","first-page":"e2012578118","DOI":"10.1073\/pnas.2012578118","volume":"118","author":"S Bamashmous","year":"2021","unstructured":"Bamashmous S, Kotsakis GA, Kerns KA, Leroux BG, Zenobia C, Chen D, Trivedi HM, McLean JS, Darveau RP (2021) Human variation in gingival inflammation. Proc Natl Acad Sci U S A 118(27):e2012578118. https:\/\/doi.org\/10.1073\/pnas.2012578118","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"Suppl 16","key":"5081_CR7","doi-asserted-by":"publisher","first-page":"S71","DOI":"10.1111\/jcpe.12366","volume":"42","author":"IL Chapple","year":"2015","unstructured":"Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, Madianos P, Louropoulou A, Machtei E, Donos N et al (2015) Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 42(Suppl 16):S71\u2013S76. https:\/\/doi.org\/10.1111\/jcpe.12366","journal-title":"J Clin Periodontol"},{"issue":"11","key":"5081_CR8","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1111\/j.1600-051X.2009.01478.x","volume":"36","author":"M Quirynen","year":"2009","unstructured":"Quirynen M, Dadamio J, Van den Velde S et al (2009) Characteristics of 2000 patients who visited a halitosis clinic. J Clin Periodontol 36(11):970\u2013975. https:\/\/doi.org\/10.1111\/j.1600-051X.2009.01478.x","journal-title":"J Clin Periodontol"},{"issue":"1","key":"5081_CR9","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1111\/prd.12257","volume":"79","author":"C Valkenburg","year":"2000","unstructured":"Valkenburg C, Van der Weijden FA, Slot DE (2000) Plaque control and reduction of gingivitis: the evidence for dentifrices. Periodontol 79(1):221\u2013232. https:\/\/doi.org\/10.1111\/prd.12257","journal-title":"Periodontol"},{"issue":"Suppl 16","key":"5081_CR10","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1111\/jcpe.12359","volume":"42","author":"FA Van der Weijden","year":"2015","unstructured":"Van der Weijden FA, Slot DE (2015) Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis a meta review. J Clin Periodontol 42(Suppl 16):S77\u2013S91. https:\/\/doi.org\/10.1111\/jcpe.12359","journal-title":"J Clin Periodontol"},{"issue":"1","key":"5081_CR11","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1111\/j.1600-0757.2009.00337.x","volume":"55","author":"F Van der Weijden","year":"2000","unstructured":"Van der Weijden F, Slot DE (2000) Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontol 55(1):104\u2013123. https:\/\/doi.org\/10.1111\/j.1600-0757.2009.00337.x","journal-title":"Periodontol"},{"issue":"2","key":"5081_CR12","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1902\/jop.2008.070345","volume":"79","author":"GT Ter\u00e9zhalmy","year":"2008","unstructured":"Ter\u00e9zhalmy GT, Bartizek RD, Biesbrock AR (2008) Plaque-removal efficacy of four types of dental floss. J Periodontol 79(2):245\u2013251. https:\/\/doi.org\/10.1902\/jop.2008.070345","journal-title":"J Periodontol"},{"issue":"8","key":"5081_CR13","doi-asserted-by":"publisher","first-page":"5273","DOI":"10.1007\/s00784-022-04495-w","volume":"26","author":"AB Londero","year":"2022","unstructured":"Londero AB, Reiniger APP, Tavares RCR, Ferreira CM, Wikesj\u00f6 UME, Kantorski KZ, Moreira CHC (2022) Efficacy of dental floss in the management of gingival health: a randomized controlled clinical trial. Clin Oral Investig 26(8):5273\u20135280. https:\/\/doi.org\/10.1007\/s00784-022-04495-w","journal-title":"Clin Oral Investig"},{"issue":"4","key":"5081_CR14","doi-asserted-by":"publisher","first-page":"480","DOI":"10.4103\/ejd.ejd_142_17","volume":"11","author":"MA Nazir","year":"2017","unstructured":"Nazir MA, Almas K, Majeed MI (2017) The prevalence of halitosis (oral malodor) and associated factors among dental students and interns, Lahore. Pakistan Eur J Dent 11(4):480\u2013485. https:\/\/doi.org\/10.4103\/ejd.ejd_142_17","journal-title":"Pakistan Eur J Dent"},{"issue":"4","key":"5081_CR15","first-page":"212","volume":"13","author":"MP Carr","year":"2000","unstructured":"Carr MP, Rice GL, Horton JE (2000) Evaluation of floss types for interproximal plaque removal. Am J Dent 13(4):212\u2013214","journal-title":"Am J Dent"},{"key":"5081_CR16","doi-asserted-by":"publisher","unstructured":"Poklepovic T, Worthington HV, Johnson TM, Sambunjak D, Imai P, Clarkson JE, Tugwell P (2013) Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev (12):CD009857. https:\/\/doi.org\/10.1002\/14651858.CD009857.pub2","DOI":"10.1002\/14651858.CD009857.pub2"},{"issue":"5","key":"5081_CR17","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1002\/JPER.17-0368","volume":"89","author":"GA Kotsakis","year":"2018","unstructured":"Kotsakis GA, Lian Q, Ioannou AL, Michalowicz BS, John MT, Chu H (2018) A network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation. J Periodontol 89(5):558\u2013570. https:\/\/doi.org\/10.1002\/JPER.17-0368","journal-title":"J Periodontol"},{"issue":"11","key":"5081_CR18","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1038\/s41415-022-4360-1","volume":"232","author":"C Turner","year":"2022","unstructured":"Turner C (2022) Interdental brushes and ISO standards. Br Dent J 232(11):761\u2013762. https:\/\/doi.org\/10.1038\/s41415-022-4360-1","journal-title":"Br Dent J"},{"issue":"2","key":"5081_CR19","first-page":"57","volume":"23","author":"CR Goyal","year":"2012","unstructured":"Goyal CR, Lyle DM, Qaqish JG, Schuller R (2012) The addition of a water flosser to power tooth brushing: effect on bleeding, gingivitis, and plaque. J Clin Dent 23(2):57\u201363","journal-title":"J Clin Dent"},{"issue":"2","key":"5081_CR20","first-page":"37","volume":"24","author":"CR Goyal","year":"2013","unstructured":"Goyal CR, Lyle DM, Qaqish JG, Schuller R (2013) Evaluation of the plaque removal efficacy of a water flosser compared to string floss in adults after a single use. J Clin Dent 24(2):37\u201342","journal-title":"J Clin Dent"},{"issue":"1","key":"5081_CR21","first-page":"23","volume":"27","author":"DM Lyle","year":"2016","unstructured":"Lyle DM, Goyal CR, Qaqish JG, Schuller R (2016) Comparison of water flosser and interdental brush on plaque removal: a single-use pilot study. J Clin Dent 27(1):23\u201326","journal-title":"J Clin Dent"},{"issue":"6","key":"5081_CR22","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1111\/j.1600-051x.1995.tb00173.x","volume":"22","author":"TF Flemmig","year":"1995","unstructured":"Flemmig TF, Epp B, Funkenhauser Z, Newman MG, Kornman KS, Haubitz I, Klaiber B (1995) Adjunctive supragingival irrigation with acetylsalicylic acid in periodontal supportive therapy. J Clin Periodontol 22(6):427\u2013433. https:\/\/doi.org\/10.1111\/j.1600-051x.1995.tb00173.x","journal-title":"J Clin Periodontol"},{"issue":"1","key":"5081_CR23","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1002\/JPER.18-0637","volume":"91","author":"FO Costa","year":"2020","unstructured":"Costa FO, Costa AA, Cota LOM (2020) The use of interdental brushes or oral irrigators as adjuvants to conventional oral hygiene associated with recurrence of periodontitis in periodontal maintenance therapy: A 6-year prospective study. J Periodontol 91(1):26\u201336. https:\/\/doi.org\/10.1002\/JPER.18-0637","journal-title":"J Periodontol"},{"issue":"2","key":"5081_CR24","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1034\/j.1600-051x.2000.027002134.x","volume":"27","author":"CW Cutler","year":"2000","unstructured":"Cutler CW, Stanford TW, Abraham C, Cederberg RA, Boardman TJ, Ross C (2000) Clinical benefits of oral irrigation for periodontitis are related to reduction of pro-inflammatory cytokine levels and plaque. J Clin Periodontol 27(2):134\u2013143. https:\/\/doi.org\/10.1034\/j.1600-051x.2000.027002134.x","journal-title":"J Clin Periodontol"},{"issue":"1","key":"5081_CR25","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s00056-005-0344-4","volume":"66","author":"C Kossack","year":"2005","unstructured":"Kossack C, Jost-Brinkmann PG (2005) Plaque and gingivitis reduction in patients undergoing orthodontic treatment with fixed appliances\u2014comparison of toothbrushes and interdental cleaning aids. A 6-month clinical single-blind trial. J Orofac Orthop 66(1):20\u201338. https:\/\/doi.org\/10.1007\/s00056-005-0344-4","journal-title":"J Orofac Orthop"},{"issue":"1","key":"5081_CR26","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1007\/s00784-021-04044-x","volume":"26","author":"S T\u00fct\u00fcnc\u00fco\u011flu","year":"2022","unstructured":"T\u00fct\u00fcnc\u00fco\u011flu S, Cetinkaya BO, Pamuk F, Avci B, Keles GC, Kurt-Bayrakdar S, L\u00fctfio\u011flu M (2022) Clinical and biochemical evaluation of oral irrigation in patients with peri-implant mucositis: a randomized clinical trial. Clin Oral Investig 26(1):659\u2013671. https:\/\/doi.org\/10.1007\/s00784-021-04044-x","journal-title":"Clin Oral Investig"},{"issue":"10","key":"5081_CR27","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1902\/jop.1991.62.10.602","volume":"62","author":"JE Lofthus","year":"1991","unstructured":"Lofthus JE, Waki MY, Jolkovsky DL, Otomo-Corgel J, Newman MG, Flemmig T, Nachnani S (1991) Bacteremia following subgingival irrigation and scaling and root planing. J Periodontol 62(10):602\u2013607. https:\/\/doi.org\/10.1902\/jop.1991.62.10.602","journal-title":"J Periodontol"},{"issue":"2","key":"5081_CR28","first-page":"146","volume":"36","author":"DL Jolkovsky","year":"2015","unstructured":"Jolkovsky DL, Lyle DM (2015) Safety of a water flosser: a literature review. Compend Contin Educ Dent 36(2):146\u20139","journal-title":"Compend Contin Educ Dent"},{"issue":"2","key":"5081_CR29","doi-asserted-by":"publisher","first-page":"e169","DOI":"10.4317\/jced.56153","volume":"12","author":"M Alharbi","year":"2020","unstructured":"Alharbi M, Farah R (2020) Effect of water-jet flossing on surface roughness and color stability of dental resin-based composites. J Clin Exp Dent 12(2):e169\u2013e177. https:\/\/doi.org\/10.4317\/jced.56153","journal-title":"J Clin Exp Dent"},{"issue":"7","key":"5081_CR30","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1111\/j.1600-051X.2011.01730.x","volume":"38","author":"NG Uzel","year":"2011","unstructured":"Uzel NG, Teles FR, Teles RP, Song XQ, Torresyap G, Socransky SS, Haffajee AD (2011) Microbial shifts during dental biofilm re-development in the absence of oral hygiene in periodontal health and disease. J Clin Periodontol 38(7):612\u2013620. https:\/\/doi.org\/10.1111\/j.1600-051X.2011.01730.x","journal-title":"J Clin Periodontol"},{"key":"5081_CR31","doi-asserted-by":"publisher","DOI":"10.1111\/idh.12617","author":"GCLS do Amaral","year":"2022","unstructured":"do Amaral GCLS, Hassan MA, Sloniak MC, Pannuti CM, Romito GA, Villar CC (2022) Effects of antimicrobial mouthwashes on the human oral microbiome: Systematic review of controlled clinical trials. Int J Dent Hyg. https:\/\/doi.org\/10.1111\/idh.12617","journal-title":"Int J Dent Hyg"},{"key":"5081_CR32","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1186\/s12866-016-0833-1","volume":"16","author":"HG Saleem","year":"2016","unstructured":"Saleem HG, Seers CA, Sabri AN, Reynolds EC (2016) Dental plaque bacteria with reduced susceptibility to chlorhexidine are multidrug resistant. BMC Microbiol 16:214. https:\/\/doi.org\/10.1186\/s12866-016-0833-1","journal-title":"BMC Microbiol"},{"issue":"11","key":"5081_CR33","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1111\/jcpe.12771","volume":"44","author":"M Brousseau-Nault","year":"2017","unstructured":"Brousseau-Nault M, Kizhakkedathu JN, Kim H (2017) Chronic periodontitis is associated with platelet factor 4 (PF4) secretion: a pilot study. J Clin Periodontol 44(11):1101\u20131111. https:\/\/doi.org\/10.1111\/jcpe.12771","journal-title":"J Clin Periodontol"},{"issue":"11","key":"5081_CR34","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1111\/jcpe.13534","volume":"48","author":"R Lira-Junior","year":"2021","unstructured":"Lira-Junior R, Bissett SM, Preshaw PM, Taylor JJ, Bostr\u00f6m EA (2021) Levels of myeloid-related proteins in saliva for screening and monitoring of periodontal disease. J Clin Periodontol 48(11):1430\u20131440. https:\/\/doi.org\/10.1111\/jcpe.13534","journal-title":"J Clin Periodontol"},{"issue":"10","key":"5081_CR35","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1111\/jcpe.12798","volume":"44","author":"PK Sreenivasan","year":"2017","unstructured":"Sreenivasan PK, Tischio-Bereski D, Fine DH (2017) Reduction in bacteremia after brushing with a triclosan\/copolymer dentifrice\u2014a randomized clinical study. J Clin Periodontol 44(10):1020\u20131028. https:\/\/doi.org\/10.1111\/jcpe.12798","journal-title":"J Clin Periodontol"},{"issue":"1","key":"5081_CR36","doi-asserted-by":"publisher","first-page":"69","DOI":"10.3390\/microorganisms9010069","volume":"9","author":"A Butera","year":"2020","unstructured":"Butera A, Gallo S, Maiorani C, Molino D, Chiesa A, Preda C, Esposito F, Scribante A (2020) Probiotic alternative to chlorhexidine in periodontal therapy: evaluation of clinical and microbiological parameters. Microorganisms 9(1):69. https:\/\/doi.org\/10.3390\/microorganisms9010069","journal-title":"Microorganisms"},{"issue":"4","key":"5081_CR37","doi-asserted-by":"publisher","first-page":"483","DOI":"10.5056\/jnm14052","volume":"20","author":"HJ Lee","year":"2014","unstructured":"Lee HJ, Kim HM, Kim N et al (2014) Association between halitosis diagnosed by a questionnaire and halimeter and symptoms of gastroesophageal reflux disease. J Neurogastroenterol Motil 20(4):483\u2013490. https:\/\/doi.org\/10.5056\/jnm14052","journal-title":"J Neurogastroenterol Motil"},{"key":"5081_CR38","doi-asserted-by":"publisher","first-page":"845738","DOI":"10.3389\/fcimb.2022.845738","volume":"12","author":"Y Tu","year":"2022","unstructured":"Tu Y, Zhou Z, Shu C, Zhou Y, Zhou X (2022) The crosstalk between saliva bacteria and fungi in early childhood caries. Front Cell Infect Microbiol 12:845738. https:\/\/doi.org\/10.3389\/fcimb.2022.845738","journal-title":"Front Cell Infect Microbiol"},{"issue":"4","key":"5081_CR39","first-page":"81","volume":"29","author":"CR Goyal","year":"2018","unstructured":"Goyal CR, Qaqish JG, Schuller R, Lyle DM (2018) Evaluation of the addition of a water flosser to manual brushing on gingival health. J Clin Dent 29(4):81\u201386","journal-title":"J Clin Dent"},{"issue":"3","key":"5081_CR40","first-page":"71","volume":"16","author":"CM Barnes","year":"2005","unstructured":"Barnes CM, Russell CM, Reinhardt RA, Payne JB, Lyle DM (2005) Comparison of irrigation to floss as an adjunct to tooth brushing: effect on bleeding, gingivitis, and supragingival plaque. J Clin Dent 16(3):71\u201377","journal-title":"J Clin Dent"},{"issue":"3","key":"5081_CR41","first-page":"170","volume":"41","author":"DM Lyle","year":"2020","unstructured":"Lyle DM, Qaqish JG, Goyal CR, Schuller R (2020) Efficacy of the use of a water flosser in addition to an electric toothbrush on clinical signs of inflammation: 4-week randomized controlled trial. Compend Contin Educ Dent 41(3):170\u2013177","journal-title":"Compend Contin Educ Dent"},{"issue":"2","key":"5081_CR42","first-page":"55","volume":"13","author":"JA Frascella","year":"2000","unstructured":"Frascella JA, Fern\u00e1ndez P, Gilbert RD, Cugini M (2000) A randomized, clinical evaluation of the safety and efficacy of a novel oral irrigator. Am J Dent 13(2):55\u20138","journal-title":"Am J Dent"},{"issue":"4","key":"5081_CR43","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1111\/j.1601-5037.2008.00343.x","volume":"6","author":"A Husseini","year":"2008","unstructured":"Husseini A, Slot DE, Van der Weijden GA (2008) The efficacy of oral irrigation in addition to a toothbrush on plaque and the clinical parameters of periodontal inflammation: a systematic review. Int J Dent Hyg 6(4):304\u2013314. https:\/\/doi.org\/10.1111\/j.1601-5037.2008.00343.x","journal-title":"Int J Dent Hyg"},{"issue":"2","key":"5081_CR44","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1111\/j.1574-6968.2009.01748.x","volume":"299","author":"SM Guan","year":"2009","unstructured":"Guan SM, Shu L, Fu SM, Liu B, Xu XL, Wu JZ (2009) Prevotella intermedia upregulates MMP-1 and MMP-8 expression in human periodontal ligament cells. FEMS Microbiol Lett 299(2):214\u2013222. https:\/\/doi.org\/10.1111\/j.1574-6968.2009.01748.x","journal-title":"FEMS Microbiol Lett"},{"issue":"10","key":"5081_CR45","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1038\/nrmicro2873","volume":"10","author":"G Hajishengallis","year":"2012","unstructured":"Hajishengallis G, Darveau RP, Curtis MA (2012) The keystone-pathogen hypothesis. Nat Rev Microbiol 10(10):717\u2013725. https:\/\/doi.org\/10.1038\/nrmicro2873","journal-title":"Nat Rev Microbiol"},{"issue":"2","key":"5081_CR46","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.jmii.2016.04.007","volume":"51","author":"CY Tsai","year":"2018","unstructured":"Tsai CY, Tang CY, Tan TS, Chen KH, Liao KH, Liou ML (2018) Subgingival microbiota in individuals with severe chronic periodontitis. J Microbiol Immunol Infect 51(2):226\u2013234. https:\/\/doi.org\/10.1016\/j.jmii.2016.04.007","journal-title":"J Microbiol Immunol Infect"},{"key":"5081_CR47","doi-asserted-by":"publisher","first-page":"124","DOI":"10.3389\/fcimb.2018.00124","volume":"8","author":"M Shi","year":"2018","unstructured":"Shi M, Wei Y, Hu W, Nie Y, Wu X, Lu R (2018) The subgingival microbiome of periodontal pockets with different probing depths in chronic and aggressive periodontitis: a pilot study. Front Cell Infect Microbiol 8:124. https:\/\/doi.org\/10.3389\/fcimb.2018.00124","journal-title":"Front Cell Infect Microbiol"},{"issue":"1","key":"5081_CR48","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1111\/prd.12111","volume":"71","author":"S De Geest","year":"2000","unstructured":"De Geest S, Laleman I, Teughels W, Dekeyser C, Quirynen M (2000) Periodontal diseases as a source of halitosis: a review of the evidence and treatment approaches for dentists and dental hygienists. Periodontol 71(1):213\u2013227. https:\/\/doi.org\/10.1111\/prd.12111","journal-title":"Periodontol"},{"issue":"2","key":"5081_CR49","doi-asserted-by":"publisher","first-page":"198","DOI":"10.15644\/asc55\/2\/9","volume":"55","author":"L Musi\u0107","year":"2021","unstructured":"Musi\u0107 L, Par M, Peru\u010di\u0107 J, Badovinac A, Plan\u010dak D, Puhar I (2021) Relationship between halitosis and periodontitis: a pilot study. Acta Stomatol Croat 55(2):198\u2013206. https:\/\/doi.org\/10.15644\/asc55\/2\/9","journal-title":"Acta Stomatol Croat"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-023-05081-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-023-05081-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-023-05081-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T06:18:19Z","timestamp":1691648299000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-023-05081-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,25]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["5081"],"URL":"https:\/\/doi.org\/10.1007\/s00784-023-05081-4","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,25]]},"assertion":[{"value":"21 November 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"XX reports grants from Bixdo SH Healthcare Technology Co., Ltd., Shanghai, China, during the conduct of the study. XC reports grants from Science and Technology Bureau of Chengdu, China, during the conduct of the study. YL reports three patents licensed. The authors YZ, CL, LZ, LZ, and HL declare no conflict of interest regarding this work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was approved by the Research Ethics Committee of West China Hospital of Stomatology (WCHSIRB-D-2020-309). The study procedures were conducted in accordance with the principles outlined in the Declaration of Helsinki and complied with the laws and regulations covering Good Clinical Practice (GCP) in China. All participants provided written informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}},{"value":"XX reports grants from Bixdo SH Healthcare Technology Co., Ltd., Shanghai, China, during the conduct of the study. XC reports grants from Science and Technology Bureau of Chengdu, China, during the conduct of the study. YL reports three patents licensed. The authors YZ, CL, LZ, LZ, and HL declare no conflict of interest regarding this work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}