Preventive measures and Oral Health in Children Undergoing Orthodontic Treatment

Objective: To evaluate the effect of repeated oral hygiene instructions, dietary consultation and frequent fluoride application on oral health in children undergoing orthodontic treatment. Materials and Methods: Forty healthy subjects, aged 7-15 years (mean=10.93±2.78) were examined prior to orthodontic treatment, 3, and 6 months during treatment. Each evaluation included a clinical check up: caries status (number of carious/restored teeth), gingival index (GI) and plaque index (PI). Microbial levels of Mutans Streptococci (MS), Lactobacilli (LB) and salivary buffer capacity were assessed, using CRT kits at baseline, and after 3 months. Oral hygiene instructions and dietary advice were given at each visit, as well as fluoride application (Duraphat). Results: Mean number of carious lesions and/or restorations was 1.43±1.85 at baseline. At 3 and 6 months during treatment mean scores were 2±2.35 and 3.14±2.48 respectively. Statistical significance was observed between the scores at baseline and at the 6 months (p=0.003). Mean GI was 0.82±0.49 prior to treatment, and 0.86±0.5 and 1.08±0.54 at 3 and 6 months. Mean PI scores were 0.89±0.48 and 0.87±0.51 prior to treatment and at 3 months. PI increased significantly after 6 months (1.14±0.52, p‹ 0.05). Microbial levels and buffer capacity obtained from salivary samples were not significantly different. Conclusions: Insertions of orthodontic appliances caused a significant decrease in oral hygiene and number of carious lesions, despite frequent sessions of oral hygiene instructions and fluoride applications. The increase in carious lesions and PI after the 3 months-visit with no subsequent increase in SM or LB may point to accumulation of other types of bacteria in the biofilm during this period.