Oral health promotion programmes during orthodontic treatment beneficial

The Cochrane Central Register of Controlled Trials, Medline and Embase databases were searched. A hand search was made of the American Journal of Orthodontics and Dentofacial Orthopaedics, (British) Journal of Orthodontics, European Journal of Orthodontics and Angle Orthodontist, Google Scholar and the reference lists of relevant articles.

Only randomised controlled trials (RCT) and quasi-randomised controlled clinical trials (CCT), which specifically stated that they assessed reductions in dental plaque levels and/ or gingival bleeding when comparing oral health promotion (OHP) interventions, were included. Trials that involved plaque removal by a professional (except at baseline) or the use of proprietary antiplaque agents were excluded.

Data extraction was carried out independently by two reviewers. Study quality was assessed for their method of allocation, concealment of allocation, masking of assessment and reporting of withdrawals. Direct comparison between the trials was difficult because of the heterogeneity in the outcome measures between the included studies.

Six RCT and quasi-randomised CCT met the inclusion criteria. Positive effects on plaque and/ or gingival health were produced in only four of the included trials. OHP did not result in any detectable difference in two of the included trials. None of the trials that were included produced a negative effect of orthodontic OHP on oral hygiene and gingival health.

An OHP programme for people undergoing fixed appliance orthodontic treatment produces a short-term reduction (of up to 5 months) in plaque and improvement in gingival health. No particular OHP method produced a greater short-term benefit to periodontal health during fixed appliance orthodontic treatment. Further studies using appropriate methods and, in particular,r longer followup periods are required.