96 third-year pre-clinical dental students, of which none were users of floss or interdental brushes, were included in the study. They all took part of the Individual Interproximal Oral Prophylaxis Education Program, an education in several steps. The first theoretical parts focus on the effect of the interdental biofilm and how to prevent and treat its consequences. The next step consists of practical clinical training. Eventually, the influence of the education module was evaluated.
One week after completion of the specific programme, 86 of 96 students used interdental brushes, after one month 61, after three months 70, and at the one-year follow-up, 20 students were interdental brush users. As seen, there was a high initial acceptance of the use of interdental brushes, but the adherence after one year must be considered low. According to the authors, one explanation could be the students' perception of a limited need for this type of interdental cleaning device among a young and healthy population.
The three variables acceptability, traumatism and perceived efficacy were overall positive among the participants. During the one-year period, there was an apparent increase in the student group in recommending interdental brushes to patients and relatives - independent of personal use. It seems that the most critical factors for the recommendation of interdental brushes are these: an understanding of preventive strategies, the perception of bleeding reduction, and knowledge regarding the efficiency of interdental brushes.
The overall goal of the education is to ensure an understanding that the use of interdental brushes in managing the interdental biofilm is just as evident as the use of toothbrushes. The message from the authors is clear: a solid education in the importance of interdental hygiene enables the students to become caregivers who fully understand the necessity of a preventive approach and can handle the patients' interdental biofilm professionally.