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All content following this page was uploaded by Niwat Anuwongnukroh on 30 January 2018.
ISSN: 2161-1122
Dentistry Anuwongnukroh et al., Dentistry 2017, 7:10
DOI: 10.4172/2161-1122.1000457
Abstract
Objective: To assess oral hygiene behavior among patients undergoing orthodontic treatment with fixed
appliances.
Material and Method: One hundred and five orthodontic patients (33 males and 72 females) treated with fixed
appliances at the Orthodontic Clinic, Department of Orthodontics, Faculty of Dentistry, Mahidol University, Thailand
were studied. Patients were requested to fill out a structured questionnaire regarding the reason for seeking
orthodontic treatment, the necessity of orthodontic treatment in daily life, oral hygiene behavior after placement of
fixed orthodontic appliances. The data was analyzed to determine the frequency distribution and percentage ratio for
each of the variables.
Results: Approximately 83% of the patient sought orthodontic treatment for esthetic tooth alignment and 85.7%
reported orthodontic treatment was necessary in their daily lives. During orthodontic treatment, 61% of the patients
used orthodontic toothbrush, 81.9% used fluoride toothpaste. Percentage of regular and occasional uses of dental
floss were 19% and 60% Similarly the use of regular and occasional use of mouth wash was 23.8% and 55.2%,
toothpick 21% and 51.4%, and interdental brush 36.2% and 51.4%. Approximately 45% of the patients brushed their
teeth in the morning and before bed, 28.6% brushed after meals, and 25.7% brushed every time after meals or
snacks. About 83% reported that their orthodontists or dental assistants instructed them how to brush their teeth.
Only 52.4% of the patients received instructions about oral hygiene care supplements.
Conclusion: Most patients sought orthodontic treatment for esthetic tooth alignment and reported the necessity
of orthodontic treatment in daily life. Although most of the patients used fluoride toothpaste, orthodontists and dental
assistants should increase their awareness for instructing their patients in oral hygiene care to prevent caries and
periodontal disease during fixed orthodontic treatment. Oral hygiene instruction is essential in all cases of
orthodontic treatment and the use of adjuncts must be reinforced.
Keywords: Oral hygiene behavior; Orthodontic treatment; Fixed hygiene behavior among patients undergoing orthodontic treatment
appliance with fixed appliances.
Page 2 of 5
Morning 0%
Results
Before going to bed 0%
From Tables 1 and 2, when the patients were asked regarding the
reason to seek orthodontic treatment, they were allowed to choose Morning +before going to bed 44.8%
more than one answer. The most to the least frequent reason for them
to seek orthodontic treatment were: 82.9% mal-alignment of teeth; After meals 28.6%
21% malocclusion such as inefficient chewing; 19.0% dentist’s After every meal and snack 25.7%
suggestion; 11.4% difficult to clean their teeth; 10.5% dentofacial
anomalies; 10.5% parent’s suggestion; 6.7% influenced by their friends; If toothbrush is not available after meals, how do you
clean your teeth?
3.8% other reasons, and 1.9% fashion trend.
Rinse the mouth 90.5%
Malocclusion such as chewing/ bite 21%
Toothpicks 9.5%
Mal-alignment of teeth such as crowding, protrusion, crossbite etc. 82.90%
Others 1%
Parent’s suggestion 10.50%
Influenced from friends 6.70% Table 3: Oral hygiene behavior (Percentage of respondents, n=105).
Dento-facial anomalies, skeletal anomalies 10.50%
Regarding the supplemental tools, percentage of daily and
Dentist’s suggestion 19.00% occasional uses of dental floss were 19% and 60% (mouth wash 23.8%
and 55.2%, toothpick 21% and 51.4%, interdental brush 36.2% and
Fashion trend 1.90% 51.4%). Approximately 45% of the patients cleaned their teeth in the
Difficulty to clean the teeth 11.40%
morning and before going to bed, 28.6% brushed after meals and
25.7% brushed after every meal or snack. In case of inability to brush
Others 3.80% after meals, 90.5% rinsed their mouth (Table 4).
Orthodontic tooth brush 61% Table 5: Awareness for oral hygiene (Percentage of respondents,
n=105).
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Page 4 of 5
(1) mechanical plaque removal – tooth brushing, flossing, and regular 11. Kiyak HA (2008) Does orthodontic treatment affect patients’ quality of
prophylaxis (2) fluoride therapy– at-home use of fluoridated life? J Dent Educ 72: 886-894.
toothpaste and mouth rinse and in-office use of topical fluoride (3) 12. Artun J, Brobakken BO (1986) Prevalence of carious white spots after
mechanical protection of tooth surfaces–sealants and glass ionomer orthodontic with multibonded appliances. Eur J Orthod 8: 229-234.
cements (4) diet – reduction in consumption of foods that cause 13. Morrow D, Wood DP, Speechley M (1992) Clinical effect of subgingival
acidity in the oral environment (5) motivational communication– chlorhexidine irrigation on gingivitis in adolescent orthodontic patients.
Am J Orthod dentofac Orthop 101: 408-413.
discussion of proper oral hygiene promotion and disease prevention
directly to the patients before treatment, repeating instructions during 14. Zachrisson BU, Zachrisson S (1972) Gingival condition associated with
partial orthodontic treatment. Acta Odontologica Scandinavica 30:
and at the end of treatment with emphasis on oral health and esthetic 127-136.
benefits.
15. Zachrisson BU, Zachrisson S (1971) Caries incidence and oral hygiene
Besides orthodontic treatment, the importance of dental hygiene during orthodontic treatment. Eur J Oral Science 79: 394-401.
maintenance procedures and treatment should also be emphasized 16. Patricia ON, Carolina GB, Carolina SW, Karyne VN, Karine T, et al.
before and during major medical treatments, such as joint replacement (2013) Periodontal evaluation of different toothbrushing techniques in
patients with fixed orthodontic appliances. Dental Press J Orthod 18:
[37], and chemo- and radio-therapy for head and neck cancer [38],
76-80.
etc., as a preventive measure to reduce the risk of oral hygiene
17. Williams P, Fenwik A, Schou L, Adams W (1987) A clinical trial of an
deterioration or interceptive therapy when the patient may be orthodontic toothbrush. Eur J Orthod 9: 295-304.
temporarily impaired to carry out daily oral hygiene procedures or in
18. Kiliçoğlu H, Yildirim M, Polater H (1997) Comparison of the
patients with low compliance or high caries index. effectiveness of two types of toothbrushes on the oral hygiene of patients
undergoing orthodontic treatment with fixed appliances. Am J Orthod
Conclusions Dentofacial Orthop 111: 591-594.
19. Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, et al.
According to the present study, most patients sought orthodontic (2014) Powered versus manual toothbrushing for oral health. Cochrane
treatment for esthetic tooth alignment and reported the necessity of Database Syst Rev 6: CD002281.
orthodontic treatment in daily life. Although most of the patients used 20. American Academy of Pediatric Dentistry (2013) Guideline on infant oral
orthodontic toothbrush, fluoridated toothpaste, and some health care. Pediatr Dent 35: 137-141.
supplementary tool of brushing, there was inadequate emphasis in the 21. Sudjalim TR, Woods MG, Manton DJ (2006) Prevention of white spot
oral hygiene instructions. Orthodontists or dental assistants should lesions in orthodontic practices: a contemporary review. Aus Dent J 51:
increase their awareness for instructing their patients on how to 284-289.
maintain good oral hygiene during fixed orthodontic treatment in 22. De la Rosa MR, Guerra JZ, Johnson DA, Radike AW (1979) Plaque
order to prevent caries and periodontal disease during orthodontic growth and removal with daily brushing. J Periodontal 50: 661-664.
treatment. Oral hygiene instruction is essential in all cases of 23. Zanata Fabricio MC, Cassiano R (2011) Association between dental floss
use and gingival conditions in orthodontic patients. Am J Orthod and
orthodontic treatment and the use of adjuncts must be reinforced.
Dentofacial Orthop 140: 812-821.
24. Imai P, Yu X, MacDonald D (2012) Comparison of interdental brush to
References dental floss for reduction of clinical parameters of periodontal disease: A
systematic review. Can J Dent Hygiene 46: 63-78.
1. O’Reilly MM, Featherstone JDB (1987) Demineralization and
remineralization around orthodontic appliances: an in vivo study. Am J 25. Kiger RD, Nylund K, Feller RP (1991) A comparison of proximal plaque
Orthod Dentofacial Orthop 92: 33-40. removal using floss and interdental brushes. J Clin Periodontal 18:
681-684.
2. Bishara SE, Ostby AW (2008) White Spot Lesions: Formation, Prevention,
and Treatment. Seminars in Orthodontics 14:174-182. 26. Ishak N, Watts T (2007) A comparison of the efficacy and ease of use of
dental floss and interdental brushes in a randomized split mouth trial
3. Beyth N, Redlich M, Harrari D, Freidman M, Steinberg D (2003) Effect of
incorporating an assessment of subgingival plaque. Oral Health Prev
sustained-release chlorhexidine varnish on Streptococcus mutans and
Dent 5: 13-18.
Actinomyces viscosus in orthodontic patients. Am J Orthod Dentofacial
Orthop 123: 345-348. 27. Christou V, Timmerman MF, Van der Velden U, Van der Weijden FA
(1998) Comparison of different approaches of interdental oral hygiene:
4. Chapman J, Roberts W, Eckert G, Kula K, Gonzalez-Cabezas C (2010)
interdental brushes versus dental floss. J Periodontol 69: 759-764.
Risk factors for incidence and severity of white spot lesions during
treatment with fixed orthodontic appliances. Am J Orthod Dentofacial 28. Baehni PC, Takeuchi Y (2013) Anti-plaque agents in the prevention of
Orthop 138: 188-194. biofilm- associated oral diseases. Oral Dis 9: 23-29.
5. Lundstrom F, Krasse B (1987) Caries incidence in orthodontic patients 29. Benson PE1, Shah AA, Millett DT, Dyer F, Parkin N, et al. (2005)
with high levels of Streptococcus mutans. Eur J Orthod 9: 117-216. Fluorides, orthodontics and demineralization: a systematic review. J
Orthod 32: 102-114.
6. Zachrisson BU, Zachrisson S (1971) Caries incidence and oral hygiene
during orthodontic treatment. Scand J Dent Res 79: 394-401. 30. Geiger AM, Gorelick L, Gwinnett AJ, Benson BJ (1992) Reducing white
spot lesions in orthodontic populations with fluoride rinsing. Am J
7. Fawzan AA (2013) Reasons for seeking orthodontic treatment in Qassim
Orthod Dentofacial Orthop 101: 403-407.
region: a Pilot Study. International Dental Journal of Student’s Research 1:
58-62. 31. Hobson RS, Clark JD (1998) How UK orthodontists advise patients on
oral hygiene. Br J Orthod 25: 64-66.
8. Kiyak HA, Reichmuth M (2002) Body image issues in dental medicine.
Body image: a handbook of theory, research, and clinical practice. New 32. Berlin-Broner Y, Levin L, Ashkenazi M (2012) Awareness of
York: Guilford pp: 342-350. orthodontists regarding oral hygiene performance during active
orthodontic treatment. Eur J Paediatr Dent 13: 187-191.
9. Ellis PE, Benson PE (2002) Potential hazards of orthodontic treatment-
what your patient should know. Dent Update 29: 492-496. 33. Harrell RE (2014) Promote oral hygiene during orthodontic treatment.
Dimensions of Dental Hygiene 12: 67-71.
10. Tsakos G (2008) Combining normative and psychosocial perceptions for
assessing orthodontic treatment needs. J Dent Educ 72: 876-885.
Page 5 of 5
34. Ousehal L, Lazrak L, Es-Said R, Hamdoune H, Elquars F, et al. (2011) 37. Krivanek S, Hrubina M, Chmurny M, Rovnak M, Melisik M, et al. (2016)
Evaluation of dental plaque control in patients wearing fixed orthodontic Bilateral knee arthoplasty: Short-term results. Acta Chir Orthop
appliances: a clinical study. Int Orthod 9: 140-155. Traumatol Cech 83: 405-410.
35. Huber SJ, Vernino AR, Nanda RS (1987) Professional prophylaxis and its 38. Mallick S, Benson R, Rath GK (2016) Radiation induced oral mucositis: a
effect on the periodontium of full-banded orthodontic patients. Am J review of current literature on prevention and management. Eur Arch
Orthod Dentofacial Orthop 91: 321-327. Otorhinolaryngol 273: 2285-2293.
36. Twetman S, Petersson L, Axelsson S, Dahlgren H, Holm AK (2004)
Caries-preventive effect of sodium fluoride mouthrinses: a systematic
review of controlled clinical trials. Acta Odontol Scand 62: 223-230.