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 Table of Contents  
Year : 2021  |  Volume : 13  |  Issue : 5  |  Page : 280-283  

Self-reported knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia – A cross-sectional study

1 Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, Al Kharj, Kingdom of Saudi Arabia
2 College of Dentistry, Prince Sattam Bin Abdul Aziz University, Alkharj, Kingdom of Saudi Arabia

Date of Submission18-Nov-2020
Date of Decision18-Nov-2020
Date of Acceptance24-Nov-2020
Date of Web Publication05-Jun-2021

Correspondence Address:
Khalid Gufran
Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Alkharj
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpbs.JPBS_737_20

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Background: Periodontal disease is a common pathological oral ailment which affects the supporting structures of the teeth. Dental plaque is one of the major causes for gingivitis and periodontitis. If left untreated, this will lead to tooth loss. Studies have shown that oral prophylaxis will reduce gingival and periodontal inflammation by removing the plaque in all the surfaces. The objective was to assess knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia. Methodology: A descriptive study was conducted among people using questionnaire. Results: 96% of the subjects brushed their teeth with brush and paste. 59% of the study subjects had knowledge regarding interdental aids, whereas only 15% of them practiced it. 72% of the people mentioned that dentists gave information regarding interdental aids. Conclusions: Among the study subjects, even though there were deficits in few areas, overall knowledge about interdental aids was good and it increased with increasing level of education.

Keywords: Gingivitis, interdental aids, periodontitis, plaque

How to cite this article:
Gufran K, Alanazi KM, Alanazi AK, Alqwiri AS, Alsubaie FM, Alotaibi NM. Self-reported knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia – A cross-sectional study. J Pharm Bioall Sci 2021;13, Suppl S1:280-3

How to cite this URL:
Gufran K, Alanazi KM, Alanazi AK, Alqwiri AS, Alsubaie FM, Alotaibi NM. Self-reported knowledge and practice of interdental aids among people of Riyadh, Saudi Arabia – A cross-sectional study. J Pharm Bioall Sci [serial online] 2021 [cited 2023 Feb 2];13, Suppl S1:280-3. Available from:

   Introduction Top

Dental caries is an infectious microbiological disease of the teeth, which results in localized dissolution and destruction of the calcified tissues.[1] It is found universally, irrespective of age, caste, creed, or geographical location, and is the second most common reason for tooth loss. It is also clear that the causative and risk factor for dental caries is dental plaque.[2] Extensive research has shown that dental plaque is a paramount factor in initiation and progression of gingival and periodontal diseases too. Hence, plaque reduction is the hall mark of preventive dentistry.[2]

Effective removal of plaque by personal oral hygiene control is the most effective methodology toward the prevention of dental caries and periodontal diseases. It is established that the severity of chronic inflammatory periodontal disease depends on removal of bacterial plaque either by mechanical or by chemical means.[3]

Brushing, flossing, use of interdental cleansing aids, and oral prophylaxis are mechanical methods, but they have proved to be very time-consuming and their effectiveness depends on skills and technique of an individual carrying out the procedures.[4] Periodontitis progress faster interdentally, and plaque control in these areas is very difficult.[5] Hence, the objective of the present study is to assess the knowledge and practice of interdental cleansing aids among undergraduate and postgraduate students.

   Methodology Top

The study was conducted to assess knowledge and utilization of interdental aids in the prevention of plaque and in turn the disease associated with it among people in Riyadh, Saudi Arabia. A total of 12 questions were asked in which seven were related to the knowledge and five regarding inter dental aids and its utilization. 552 people responded to the questionnaire.

Study population

People who live in Riyadh city were included. Ethical approval was obtained from College of Dentistry, Prince Sattam Bin Abdul-Aziz University, Alkharj. Informed consent was obtained before study. Those participants denying giving consent were excluded. The questionnaire was in Arabic and English language. It was sent through social media, i.e., WhatsApp and Snap Chat, and was asked people to send link to their friends and family after answering the questions. Consent form was included in the questionnaire and those who did not agree to sign consent were excluded from the survey.

The sample size was calculated by using the formula:

where Z = 1.96 (confidence level or 5% level of significance), P = positive attitude toward prevention of oral diseases 65%, Q = (1 – P) = 100 − 75 = 35%, d = precision limit or proportion of sampling error is 4% confidence limit.

After substituting the values required, the sample size was found to be 546. Finally, a total of 552 responses were received and considered for statistical analysis.


An objective, anonymous questionnaire was prepared. Personal information (age, gender, and educational status), questions related to awareness about interdental aids, and five questions related to utilization of interdental aids were included. Educational status was classified as masters, bachelors, up to high school, and uneducated. Responses consisted of agree, disagree, and don't know for questions related to knowledge and yes and no for utilization of interdental aids.

Validation of questionnaire

to validate the questionnaire, questions were prepared in English language and then translated to Arabic language and again back translated to English.


Questionnaire was sent to individual people through social media, i.e., WhatsApp and Snap Chat, which also had a consent form and explanation about the study.

Statistical analysis

Descriptive statistics and Chi-square test were used where 95% confidence interval, and a P < 0.05 was considered statistically significant.

   Results Top

[Table 1] depicts the study population distribution according to the age group and education. The age group was from above 18 years, and majority of the participants were belonged to 18–25 years of age (55.8%). 52.5% of the participants had a bachelors' degree, and 39.3% of the subjects had education up to high school only.
Table 1: Distribution of study population according to gender, educational status, and age group

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[Table 2] majority of the participants use tooth paste and tooth powder for maintaining their oral hygiene 1.6% or less than that use tooth powder, salt, or charcoal. 42% of the study subjects correctly answered that interproximal or cleaning in between teeth is difficult. 38.2% answered that lingual surface is difficult to clean. With similar finding 47.1% of the study participants are of the view that tooth brushing does not effectively clean interproximal area was recorded the tooth brushing related question. 92.0% of the study subjects are aware that food stuck in between tooth can cause bad breath. 76.6% of the study subjects are aware that food in the interdental area can cause gingivitis. 63.2% of the study subjects use tooth pick to clean food stuck in between teeth. Dental floss is used by 26.6% of the study subjects and 10.1% of the study subjects use pin to remove the food.
Table 2: Knowledge regarding interdental aids

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[Figure 1] shows information about interdental aids. 58.5% of the study subjects have told that they have information on interdental aids.
Figure 1: Information about interdental aids among study subjects

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[Table 3] shows utilization of interdental aids among the study subjects. 15.0% of the study subjects regularly use dental floss. 63.0% of the study subjects occasionally use dental floss, and 21.9% of the study subjects never used dental floss. When information is asked about other interdental brushes by showing picture, 46.0% of the subjects have told that they have used those brushes. Surprisingly, 45.8% of the study subjects have told that they have never used mouth washes. 13.9% told that they use twice daily and 26.4% occasionally.
Table 3: Utilization of interdental aids among study subjects

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When question is asked whether the study subjects get information about interdental aids from dentist, 72.3% of the study participants told no [Figure 2].
Figure 2: Dentist providing information about interdental aids

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Regarding the source of information about interdental aids, majority of the study subjects (72.1%) have told that it is by social media. 424.5% of the study subjects told that information is passed by dentists. 2% of the subjects received information from physicians [Table 4].
Table 4: Source of information about interdental aids

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   Discussion Top

People's health is in people's hands, so they should be a good example for positive oral health attitudes and behavior to their families, patients, and friends. In general, they should motivate others about maintaining a good oral health.[6]

96% of the students in the present study brushed their teeth with tooth brush and paste daily which was in accordance with other studies.[6],[7] One-third of Kuwait and two-third of Jordanian students brushed with their teeth with tooth and paste twice a day, respectively.[8] 42% of the people said that brushing lingual surface was more difficult than others, which was in contrast to Finnish (78%) and Japanese (55%) students.[9] People gave less importance to individual tooth maintenance which suggested that the level of student's self-care is influenced by their educational levels.[6]

Only 15% of the people practiced interdental aids on a regular basis. Evidence in the literature[6],[10],[11] shows that there is lack of use of flossing as a preventive measure by the various population of the world, which was similar to the present study along with the use of rinse.

The current study subjects lacked knowledge of use of interdental aids, proper force and technique, and the use of disclosing solutions to identify deposits on the teeth. These results were in line with the studies conducted by Neeraja et al.[6] Oral health education needs to be provided in these areas to enhance the knowledge and practice of interdental.[6],[12],[13],[14],[15],[16] This improvement in personal oral health among people has linked to their educational level.[17],[18] 72% of the people said that dentists provided information regarding inter dental aids and 78% of the information is provided by social media.

   Conclusion Top

Knowledge and practice of interdental aids among people of Riyadh showed that majority of the people were quite aware and knows about interdental cleansing aids, but very few population relatively practiced it. Practicing interdental cleansing aids will help for maintaining of oral hygiene and plaque control and for preventing periodontitis. Further studies to evaluate the oral hygiene and gingival and periodontal status of subjects using toothbrush alone and combination of toothbrush along with the interdental aids are recommended. This would educate the recommendation of interdental aids regularly.


We would like to acknowledge Deanship of Scientific Research, Prince Sattam Bin Abdul Aziz University, Alkharj KSA for supporting this research and all the study participants for helping to provide information and sparing their time.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

Socransky SS, Haffajee AD. Dental biofilms: Difficult therapeutic targets. Periodontol 2000 2002;28:12-55.  Back to cited text no. 1
Marsh PD. Dental plaque as a microbial biofilm. Caries Res 2004;38:204-11.  Back to cited text no. 2
Pinto TM, de Freitas GC, Dutra DA, Kantorski KZ, Moreira CH. Frequency of mechanical removal of plaque as it relates to gingival inflammation: A randomized clinical trial. J Clin Periodontol 2013;40:948-54.  Back to cited text no. 3
Claydon NC. Current concepts in toothbrushing and interdental cleaning. Periodontol 2000 2008;48:10-22.  Back to cited text no. 4
Gluch JI. As an adjunct to tooth brushing, interdental brushes (IDBs) are more effective in removing plaque as compared with brushing alone or the combination use of tooth brushing and dental floss. J Evid Based Dent Pract 2012;12:81-3.  Back to cited text no. 5
Doshi D, Baldava P, Anup N, Sequeira PS. A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care. J Contemp Dent Pract 2007;8:68-75.  Back to cited text no. 6
Imai PH, Yu X, MacDonald D. Comparison of interdental brush to dental floss for reduction of clinical parameters of periodontal disease: A systematic review. Can J Dent Hygiene 2012;46:63-78. Available from: [Last accessed on 2012 Jan 22].  Back to cited text no. 7
Dagli RJ, Tadakamadla S, Dhanni C, Duraiswamy P, Kulkarni S. Self reported dental health attitude and behavior of dental students in India. J Oral Sci 2008;50:267-72.  Back to cited text no. 8
Neeraja R, Kayalvizhi G, Sangeetha P. Oral health attitudes and behavior among a group of dental students in Bangalore, India. Eur J Dent 2011;5:163-7.  Back to cited text no. 9
Ganss C, Schlueter N, Preiss S, Klimek J. Tooth brushing habits in uninstructed adults--Frequency, technique, duration and force. Clin Oral Investig 2009;13:203-8.  Back to cited text no. 10
Al-Omari QD, Hamasha AA. Gender-specific oral health attitudes and behavior among dental students in Jordan. J Contemp Dent Pract 2005;6:107-14.  Back to cited text no. 11
Kawamura M, Honkala E, Widström E, Komabayashi T. Cross-cultural differences of self-reported oral health behaviour in Japanese and Finnish dental students. Int Dent J 2000;50:46-50.  Back to cited text no. 12
Soh G. Understanding prevention of dental caries and gum disease in an Asian community. J Ir Dent Assoc 1991;37:6-9.  Back to cited text no. 13
Newbrun E. Preventing dental caries: Breaking the chain of transmission. J Am Dent Assoc 1992;123:55-9.  Back to cited text no. 14
Kawamura M, Spadafora A, Kim KJ, Komabayashi T. Comparison of United States and Korean dental hygiene students using the Hiroshima University-Dental Behavioural Inventory (HU-DBI). Int Dent J 2002;52:156-62.  Back to cited text no. 15
Kawamura M, Iwamoto Y, Wright FA. A comparison of self-reported dental health attitudes and behavior between selected Japanese and Australian students. J Dent Educ 1997;61:354-60.  Back to cited text no. 16
Halappa M, Chandu G. Evaluation of usage of interdental aids among dentists as a preventive measure. J Indian Soc Periodontol 2015;19:4.  Back to cited text no. 17
[PUBMED]  [Full text]  
Al-Wahadni AM, Al-Omiri MK, Kawamura M. Differences in self-reported oral health behavior between dental students and dental technology/dental hygiene students in Jordan. J Oral Sci 2004;46:191-7.  Back to cited text no. 18


  [Figure 1], [Figure 2]

  [Table 1], [Table 2], [Table 3], [Table 4]


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