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This study aimed to evaluate the effectiveness of an instruction-video, with and without additional hands-on instruction, in teaching young adults proper flossing performance. This randomised intervention and observational study included 94 participants, 24 23; 25 years, receiving an instruction-video with group 1 or without additional hands-on instruction group 2. The flossing performance was assessed by videotaping before instruction T1 , after instruction and one week of practice T2 , as well as after two weeks of practice T3.
Parameters of interest were number of interdental spaces reached, adaptation to mesial and distal surfaces, flossing technique, systematic approach and handling combined with self-assessment of flossing skills and time spent, assessed by questionnaires.
Additional hands-on instruction did not lead to a significant improvement in any parameter compared to video-instruction alone. At T1, the participants reached many interdental spaces, but only two managed to floss their entire dentition correctly.
Parameters improved again at T3, resulting in 42 participants flossing their entire dentition correctly. After instruction participants found flossing less difficult, although they estimated it took more time. Video-instruction significantly improved flossing performance, whereas hands-on instruction had no additional benefit. This indicates that video-instruction could be an effective and timesaving tool to improve flossing performance.