THE IMPORTANCE AND FEATURES OF ORAL HYGIENE MEASURES DURING ORTHODONTIC TREATMENT WITH FIXED STRUCTURES

Authors

Keywords:

orthodontic treatment, braces, daily oral hygiene, gingivitis, toothbrushes, hygiene indices, gum bleeding, statistical dependencies

Abstract

Introduction. The quality of individual oral hygiene is a crucial component in the prevention of caries and inflammatory diseases of periodontal tissues, particularly in childhood and adolescence. The regular and daily implementation of hygiene measures also plays a crucial role in ensuring the success of orthodontic treatment.The purpose is to analyze sources of evidence-based scientific literature and meta-analyses on the effectiveness of daily oral hygiene using various hygiene products and methods.Materials and methods. A comprehensive bibliographic search was conducted in the databases PubMed, Cochrane Central, EMBASE, AMED, ProQuest, CINAHL, AYUSH, Digital Helpline for Ayurveda Research Articles (DHARA), and Clinical Trial Gov using the search constructs: “braces”, “orthodontic treatment”, “daily oral hygiene during braces treatment”.Results. An effective toothbrushing technique is crucial for maintaining oral hygiene, particularly for patients who wear fixed orthodontic appliances. Traditional tooth brushing methods, developed for the general population using manual toothbrushes, do not account for the unique oral conditions of orthodontic patients, who experience increased biofilm formation. More effective in preventing the occurrence of gingivitis is the use of adapted orthodontic techniques and modified devices, such as sonic, LED, oscillating-rotating toothbrushes, and water-jet dental floss.Conclusions. The importance of quality daily hygiene in patients undergoing orthodontic treatment with fixed structures has been proven by many researchers, an effective method of prevention is the quality and frequency of tooth brushing. The use of medications is justified only in cases of disease.

References

Lienhart G, Elsa M, Farge P, Schott AM, Thivichon-Prince B, Chanelière M. Factors perceived by health professionals to be barriers or facilitators to caries prevention in children: a systematic review. BMC Oral Health. 2023 Oct 19;23(1):767. doi: 10.1186/s12903-023-03458-1. PMID: 37853400; PMCID: PMC10585780

Pattanaik S, Veeraraghavan VP, Dasari AK, Patil SR, Alzahrani SG, Fareed M. Orthodontic treatment in adults: Challenges, outcomes, and factors affecting compliance and satisfaction. J Orthod Sci. 2024 May 8;13:14. doi: 10.4103/ jos.jos_186_23. PMID: 38784082; PMCID: PMC11114451.

Smolyar N, Chukhray N, Lesitskiy M, Rybert Y, Musiy-Sementsiv K. Assessment of oral hygiene maintenance in 12–18-year-old children and teenagers with fixed orthodontic appliances. Stomatologija. 2022;24(1):21-25. PMID: 36321706.

Marusamy KO, Alsibaie RB, Mostanteq NM, Alzahrani L, Aljuhani DH, Lashkar R. Awareness and Periodontal Health Practices of Fixed Orthodontic Appliance Patients: A Questionnaire-Based Survey. Cureus. 2024 May 15;16(5):e60335. doi: 10.7759/cureus.60335. PMID: 38882991; PMCID: PMC11177247.

Smolyar N, Chukhray N, Lesitskiy M, Rybert Y, Musiy-Sementsiv K. Assessment of oral hygiene maintenance in 12–18-year-old children and teenagers with fixed orthodontic appliances. Stomatologija. 2022;24(1):21-25. PMID: 36321706.

Mei L, Kang A, Jin C, Farella M. An orthodontic tooth brushing technique to enhance oral hygiene in patients wearing fixed orthodontic appliances: A randomized controlled trial. Int J Dent Hyg. 2023 Aug;21(3):634-640. doi: 10.1111/idh.12686. Epub 2023 Apr 27. PMID: 37103919.

AlMoharib HS, Alqasem A, Almusfer G, Aldosari MA, Almadhoon HW. The effectiveness of water jet flossing and interdental flossing for oral hygiene in orthodontic patients with fixed appliances: a randomized clinical trial. BMC Oral Health. 2024 Apr 27;24(1):498. doi: 10.1186/s12903-024-04166-0. PMID: 38678246; PMCID: PMC11055227.

Erbe C, Temming T, Ohlendorf D, Schmidtmann I, Ferrari-Peron P, Mundethu A, Wehrbein H. Investigation of the inter-rater reliability of three different plaque indices used in patients with fixed orthodontic appliances. PLoS One. 2025 May 6;20(5):e0322528. doi: 10.1371/journal.pone.0322528. PMID: 40327682; PMCID: PMC12054875.

Omidkhoda M, Charbgoo M, Bagheri H, Naghibi N, Eslami N. Effect of fluorescein-containing toothpaste on dental plaque in patients with fixed orthodontic appliances: a randomized clinical trial. BMC Oral Health. 2025 Jun 3;25(1):895. doi: 10.1186/s12903-025-05977-5. PMID: 40462033; PMCID: PMC12135612.

Manphibool C, Matangkasombut O, Chantarangsu S, Chantarawaratit PO. Effects of blue-light LED toothbrush on reducing dental plaque and gingival inflammation in orthodontic patients with fixed appliances: a crossover randomized controlled trial. BMC Oral Health. 2023 May 15;23(1):293. doi: 10.1186/s12903-023-02977-1. PMID: 37189136; PMCID: PMC10184111.

Sharma P, Sharma R, Nadkerny V, Sohi HK, V S B, Rebello AA, Mehta M. Effect of toothbrush type on biofilm and periodontal health in orthodontic patients. Bioinformation. 2025 Jul 31;21(7):2171-2175. doi: 10.6026/973206300212171. PMID: 41170052; PMCID: PMC12569896.

George A, Mungara J, Vijayakumar P, Karunakaran D, Raj S, Kumar A. Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children. Int J Clin Pediatr Dent. 2025 Jun;18(6):637-640. doi: 10.5005/jp-journals-10005-3140. Epub 2025 Aug 6. PMID: 41040992; PMCID: PMC12486515.

Arockiam AS, Nandhini PN, Chandrashekaraiah P, Benzigar R, Shivananjan R. Should clinicians recommend oscillating- rotating toothbrushes over sonic models for superior plaque and gingivitis control? Evid Based Dent. 2025 Jun;26(2):99-100. doi: 10.1038/s41432-025-01143-6. Epub 2025 Apr 25. PMID: 40275115.

Adam R, Grender J, Timm H, Qaqish J, Goyal CR. A randomized controlled trial evaluating a novel oscillating-rotating electric toothbrush versus a sonic toothbrush for plaque and gingivitis. Am J Dent. 2025 Feb;38(1):3-8. PMID: 40000000.

Adam RE, Grender JM, Timm H, Qaqish J, Goyal CR. A Randomized Clinical Trial Evaluating Plaque and Gingivitis Effects of an Entry-Tier Oscillating-Rotating Electric Toothbrush. J Dent Hyg. 2025 Oct;99(5):6-17. PMID: 41022557.

Shin Y, Song W, Shin IH, Ji DW, Min KJ, Ahn SH. Optical analysis for effective phototherapy in an LED oral care device. Biomed Opt Express. 2025 Feb 6;16(3):922-934. doi: 10.1364/BOE.553671. PMID: 40109532; PMCID: PMC11919360.

Kommuri K, Michelogiannakis D, Barmak BA, Rossouw PE, Javed F. Efficacy of herbal- versus chlorhexidine-based mouthwashes towards oral hygiene maintenance in patients undergoing fixed orthodontic therapy: A systematic review and meta-analysis. Int J Dent Hyg. 2022 Feb;20(1):100-111. doi: 10.1111/idh.12567. Epub 2022 Jan 17. PMID: 34902217.

Mahjoub DT, AlJabri RK, Bifari NE, Najjar RS. Oral hygiene awareness and practice in orthodontic patients in Makkah city: A cross sectional study. J Orthod Sci. 2023 Apr 28;12:32. doi: 10.4103/jos.jos_115_22. PMID: 37351389; PMCID: PMC10282541.

Marusamy KO, Alsibaie RB, Mostanteq NM, Alzahrani L, Aljuhani DH, Lashkar R. Awareness and Periodontal Health Practices of Fixed Orthodontic Appliance Patients: A Questionnaire-Based Survey. Cureus. 2024 May 15;16(5):e60335. doi: 10.7759/cureus.60335. PMID: 38882991; PMCID: PMC11177247.

Pattanaik S, Veeraraghavan VP, Dasari AK, Patil SR, Alzahrani SG, Fareed M. Orthodontic treatment in adults: Challenges, outcomes, and factors affecting compliance and satisfaction. J Orthod Sci. 2024 May 8;13:14. doi: 10.4103/ jos.jos_186_23. PMID: 38784082; PMCID: PMC11114451.

Bilici Geçer R, Dursun D. Patients' Perspectives and Attitudes About the Relationship Between Fixed Orthodontic Treatment and Oral Hygiene. Cureus. 2024 Aug 30;16(8):e68178. doi: 10.7759/cureus.68178. PMID: 39347294; PMCID: PMC11439157.

Saikia AM, Sivasubramanian A, Muthu MS, Ganesh A, Chandrasekaran K, Kirubakaran R. Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review. Int J Clin Pediatr Dent. 2024 Apr;17(Suppl 1):S100-S111. doi: 10.5005/jp-journals-10005-2805. PMID: 39185265; PMCID: PMC11343992.

Basudan AM, Al-Zawawi AS, Divakar DD, Shaheen MY, Aldulaijan HA. Efficacy of 0.12% Chlorhexidine and Salvadora persica-based Mouthwash in Reducing Oral Candida Carriage and Periodontal Inflammation in Cigarette Smokers and Non-smokers after Non-surgical Periodontal Therapy. Oral Health Prev Dent. 2023 Jun 20;21:219-228. doi: 10.3290/j.ohpd. b4169713. PMID: 37338011; PMCID: PMC11619873.

Published

2025-12-30

Issue

Section

DENTISTRY