Orthodontic Patients’ Oral Health: Does Experiential Health Education Matter?

Objectives: Poor oral hygiene during orthodontic treatment can result in white spot lesions which ultimately compromise esthetic appearance. The objectives are to assess (a) 7-16 year old orthodontic patients’ gingival health and average plaque scores at their first appointment and one, two, and three months later, and to explore (b) if experiential health education at baseline would improve gingival health and average plaque scores more than traditional health education over time, and (c) whether gender and age affected these outcomes. .
Methods: Chart review data were collected from 133 orthodontic patients who ranged in age from 7 to 16 years. One calibrated examiner collected all chart review data. Oral hygiene efforts were rated as 0=good, 1=fair and 2=poor; gingival health was rated on a scale from 0=healthy to 3=severe inflammation; after the patient had used a disclosing tablet, plaque scores for two incisors and four molars were determined on a scale from 0=no plaque to 5=plaque covering more than two thirds of the tooth. Patients were randomly assigned to a traditional vs. an experiential health education intervention. The experiential learning intervention consisted of hands-on experiments at the first appointment.
Results: At baseline, oral hygiene efforts were on average fair (Mean=1.87); gingival health was rather positive (Mean=0.56) and plaque scores showed that patients tended to have separate flecks of plaque at cervical margins of teeth (Mean=0.78). Oral hygiene efforts (1.87 vs. 1.63;p=0.002) and plaque scores (0.77 vs. 0.58;p=0.001) improved significantly over a three months period. Participants with an experiential health education at baseline did not differ in their improvement for participants in the traditional health education group. Neither gender nor age affected oral health improvements.
Conclusions: These findings show that traditional as well as experiential health education interventions can improve pediatric and adolescent orthodontic patients’ oral hygiene efforts and plaque scores which might result in avoiding white spot lesions.