[Cariologic aspects of orthodontic treatment]

An almost linear correlation between plaque accumulation and caries lesion development has been demonstrated in orthodontic patients. Nevertheless, the present fluoride agents and regimens are sufficient to prevent lesion development to such an extent that filling therapy is not required. An increased prevalence of white spot demineralization on the buccal surfaces in orthodontically treated individuals may on the other hand represent an aesthetic problem. Fig 5 summarizes a series of experiments on the effect of fluoride on lesion development during treatment with fixed orthodontic appliances. Whereas daily rinsing with a neutral fluoride solution (0.2% NaF) inhibits lesion development by about 60%, a fluoride solution (0.6% F) at pH 1.9 inhibits lesion development completely under the same experimental conditions. The hypothesis is that the acidic fluoride solution induces an acid resistant layer of calcium fluoride-like material on the enamel surface and/or a large depot of fluoride for release during cariogenic challenges. A fluoride solution at low pH may be recommended for prevention of lesion development during treatment with fixed orthodontic appliances.