WHICH ORAL HYGIENE PROTOCOL SHOULD BE FOLLOWED BY PATIENTS WITH FIXED ORTHODONTIC APPLIANCES? A RANDOMIZED CLINICAL...

The aim of this study was to compare the effect of three different oral hygiene protocols on the amount of Streptococcus mutans (S. mutans) colonization in adult patients with fixed orthodontic appliance.

A total of 27 patients who fulfilled the eligibility criteria were randomly allocated in the study. After bonding of the fixed appliance, patients were randomly allocated into 3 groups, Group I (conventional manual toothbrushing with fluoridated toothpaste), Group II (Conventional manual toothbrushing combined with interdental brushes) and Group III (Conventional manual toothbrushing combined with interdental brushes and chlorhexidine (CHX) mouthwash). Saliva samples were collected from each patient at two timelines; Before bonding (T0) and 1 month after bonding (T1), then sent for microbial analysis to calculate S. mutans viable count (CFU/mL).

T1 vs T0: Group I showed significant increase in S. mutans viable counts (P = .0117), Group II showed no significant changes in S. mutans levels (P = .425), while Group III showed significant decrease in S. mutans viable counts (P = 0.0078). Upon comparing the three oral hygiene protocols, both group II and group III exhibited prominent impact on oral hygiene whether by maintaining or reducing S. mutans levels, respectively.

Conventional manual toothbrush combined with interdental brush protocol with or without CHX were efficient protocols for improving oral hygiene in orthodontic patients. Using conventional manual toothbrushes alone was the least effective oral hygiene protocol. Registration NCT05016713. The protocol was published before trial commencement.