The Oral Health Management in Patients With Fixed Orthodontic Treatment: An Evidence-Based Integrated Review

Area of Science:

• Orthodontics
• Dental Public Health
• Evidence-Based Dentistry

Background:

• Fixed orthodontic treatment is increasingly sought for malocclusion correction, impacting chewing function, dental health, and aesthetics.
• Potential oral health issues can arise from improper treatment timing, inadequate in-treatment management, and poor post-treatment follow-up.
• Comprehensive oral health management throughout the orthodontic treatment journey is essential.

Purpose of the Study:

• To systematically synthesize existing evidence on effective oral health management strategies for patients undergoing fixed orthodontic treatment.
• To provide a reference for healthcare professionals and patients to enhance oral health during and after orthodontic interventions.

Main Methods:

• A systematic literature search was conducted across major databases (e.g., PubMed, Cochrane Library, Web of Science) up to October 31, 2023.
• Included were guidelines, expert consensus, evidence summaries, and systematic reviews focusing on oral health management in fixed orthodontic patients.
• Literature quality was assessed using AGREE II and AMSTAR 2; evidence levels and recommendations were classified using the JBI evidence Pre-grading and Recommendation level system (2014).

Main Results:

• The review included 2 guidelines and 33 systematic reviews, encompassing 37 distinct pieces of evidence.
• Key evidence areas covered assessment, treatment timing, orthodontic material selection (including fluoride-containing options), management plan development, remote administration, patient compliance, and oral hygiene product choices (toothpaste, mouthwash, toothbrush).
• Findings highlight the importance of specific interventions for maintaining oral health during orthodontic care.

Conclusions:

• This synthesis offers best-evidence guidance for oral health management in fixed orthodontic patients, supporting both clinicians and patients.
• The findings aim to promote patient self-management and improve adherence to oral health recommendations.
• Individualized treatment strategies and management plans, considering clinical context, patient preferences, and economic factors, are recommended for optimal outcomes.