# Knowledge, awareness, and attitudes toward oral irrigator use among dentists and dental students: a cross-sectional study

## TL;DR

This study explores how much dentists and dental students know about water flossers and finds that specialists know more and recommend them more than students.

## Contribution

The study provides new insights into the knowledge and attitudes of dental professionals and students toward oral irrigators, highlighting educational gaps.

## Key findings

- Specialist and general practitioners had significantly higher knowledge about oral irrigators compared to students and interns.
- Cost was identified as the main barrier to using oral irrigators, while only a small proportion found them difficult to use.
- Specialist dentists recommended oral irrigators more frequently than other groups.

## Abstract

Interdental plaque control is critically important in maintaining oral hygiene. Oral irrigators (also known as water flossers) are recommended as an alternative oral hygiene tool, especially for individuals who have difficulty using traditional dental floss. Although numerous studies evaluate the clinical effectiveness of oral irrigators in the literature, studies examining the knowledge level, awareness, and clinical attitudes of dentists and dental students towards these devices are limited. The aim of this study is to evaluate knowledge, awareness, and attitudes regarding the use of oral irrigators and to examine the effect of education and clinical experience levels on these approaches.

A total of 421 participants were included in the study: third-year dental students (n = 100), intern dentists (n = 179), general practitioners (n = 66), and specialist dentists (n = 75). A structured questionnaire consisting of 16 questions was administered to assess knowledge, awareness, and attitudes regarding oral irrigator use. Data were analyzed using chi-square tests and Bonferroni-corrected post-hoc analyses; the statistical significance level was set at p < 0.05.

82.9% of participants reported having knowledge about oral irrigators. It was found that specialist and general practitioners had significantly higher knowledge levels regarding the periodontal effects of oral irrigators compared to students and interns (p < 0.001). 70.2% of participants rated oral irrigators as “effective” or “very effective”. While the rate of regular use was 9.0%, cost (58.0%) was identified as the primary barrier, whereas difficulty of use was reported by only a small proportion of participants (4.8%) (p < 0.001). Only 28.9% of participants stated that they had received adequate training about oral irrigators. The rate of specialist dentists recommending oral irrigators to their patients was significantly higher (61%) compared to other groups (p < 0.001).

This study reveals that knowledge, awareness, and attitudes towards oral irrigator use differ significantly depending on the level of education and clinical experience. While general awareness is high, significant gaps exist in terms of detailed knowledge, personal use, and curriculum adequacy. To effectively integrate oral irrigators into preventive dentistry practices, it is recommended that evidence-based and structured training on these devices be strengthened in dental education programs.

The online version contains supplementary material available at 10.1186/s12903-026-07956-w.