Dental Plaque Removal Study

The overall clinical response (plaque, gingivitis, bleeding) in participants with varying
stages of gingival health as well as the causative or indicative hallmarks of selected
biological responses underpinning the overt clinical manifestations described above will be
evaluated. The chief biological response that will be investigated is how a reduction in the
concentration of bacterial lipopolysaccharide endotoxins (LPS) in interproximal plaque may
influence improvements in the clinical response (e.g., through mitigation of bleeding) when
compared to a change in the plaque biomass within which a large component of the endotoxins
reside. The hypothesis is that improvements in clinical bleeding may result more from the
removal or reduction of toxic bacterial products that serve as the direct impetus of the
inflammatory response rather than from sheer bulk removal of interproximal plaque. From a
methods development perspective, this study will also assess the feasibility of measuring
endotoxin load from clinical samples. Ultimately it is anticipated that a comprehensive
evaluation of clinical benefits conferred by continuous fluid streaming will emerge upon
analysis of the relationships between clinical and biological data sets, particularly where
causal relationships may exist between both parameters.

The devices used in this study are subject only to Class I (general controls) and considered
exempt from the premarket notification procedures and not subject to section 510(k), 515, or
520(m,) of the FDC Act in order to be legally marketed. Thus, the study does not meet the
definition of an Applicable Clinical Trial.

Inclusion Criteria:

- are in good general health

- are 18 - 75 years old;

- have and will abstain from all oral care in the 12 hours prior to each scheduled
appointment, but no more than 18 hours prior.

- have and will abstain from consumption of apples and other sticky fruits in the 12
hours prior to each appointment.

- agree to abstain from eating, drinking, chewing gum, and the use of breath mints, etc
in the one hour preceding saliva collection at Visits 2 and 3

- have a minimum of 20 natural teeth (excluding 3rd molars);

- have 2 qualifying Interproximal Unit test sites in each posterior quadrant from 3
approximating teeth (see Section 5.1.1, Interproximal Unit (IU)Test Site Selection,
for definition);

- present with one of the following three categories:

- BGI-gingivitis: all PD<3mm, BOP>10%;

- BGI-periodontitis (P2): 1+ site with PD>3mm, BOP>10% but <50%

- BGI-periodontitis (P3): 1+ site with PD>3mm, BOP>50%

- have provided written informed consent and are willing to participate and be available
at all times required for participation

- are willing and able to fully understand and comply with the written and verbal study
instructions provided in English

- agree to return all study materials at the final visit

Exclusion Criteria:

- have systemic diseases, Down's syndrome, or known AIDS/HIV;

- have Diabetes

- are a smoker

- are pregnant or nursing by participant report;

- have a cardiac pacemaker or AICD

- are undergoing or require extensive dental or orthodontic treatment;

- have had oral or gum surgery in the previous 2 months;

- require antibiotic treatment for dental appointments;

- have used antibiotics within 4 weeks of enrollment

- are currently using prescription-dose anti-inflammatory medications or anticoagulants
(including aspirin)

- have heavy deposits of calculus, either supragingival and/or subgingival;

- have extensive crown or bridge work and/or rampant decay;

- currently use bleaching trays;

- have any oral or extraoral piercing on lips or in mouth with ornament or accessory;

- have a professional prophylaxis within 4 weeks of study;

- have participated in a prior study ≤ 20 days;

- participated in Philips study DRC-0742;

- are employed by an oral healthcare products company or dental research institution
(i.e., dental school: administrative staff, assistants, hygienists, and research
students).

- are a dentist, dental student or dental professional