Βασιλική Μπενέτου, Αναπληρώτρια Καθηγήτρια, Ιατρική σχολή, ΕΚΠΑ
Παγώνα Λάγιου, Καθηγήτρια, Ιατρική σχολή, ΕΚΠΑ
Φίλιππος Ορφανός, Μέλος ΕΔΙΠ, Ιατρική σχολή, ΕΚΠΑ
Patients' demands and expectations regarding the aesthetics of a smile are increasing significantly. This is a major reason why patients undergo orthodontic treatment, while medical and dental indications are less common as orthodontic reasons. Proper oral hygiene, healthy eating habits and regular dental checkups are key factors in preventing dental and periodontal disease. In spite of the benefits of the orthodontic therapy, orthodontic appliances increase the accumulation of biofilms and plaque retention around orthodontic appliances and limit the application of good oral hygiene.
The aim of this study was to investigate the factors (social-demographic, dietary and general dental factors) that are associated with the levels of oral hygiene of patients undergoing orthodontic treatment using the simplified oral hygiene index (OHI-S). The sample consisted of 218 orthodontic patients,107 men and 111 women, with mean age of 16 years, from two private orthodontic clinics inside and outside the Attica area, while the duration of data collection was approximately 3 months (December 2019 to February 2020). Data were collected through the use of a structured questionnaire, as well as, a clinical dental examination
Simple and multivariable logistic regression was applied. Orthodontic treatment, daily use of the toothbrush, daily application of interdental cleaning, bleeding gums and frequency of dental visits (for the group "per 1 year") were statistically significantly associated with the level of oral hygiene OHI-S. Gender, age, place of residence, smoking, educational level of parents and adult participants, daily consumption of sugary foods, daily consumption of vegetables/fruits, frequency of dental visits (for the group "over 1 year") and last dental cleaning were not statistically significantly associated with the level of oral hygiene.
Specifically, daily brushing (OR=0,05, 95%CI=0,00-0,52 versus non-daily brushing) and daily interdental hygiene (OR=0,23, 95%CI=0,08-0,71 versus non-daily hygiene) were inversely associated with poor / moderate oral hygiene. On the other hand, orthodontic treatment (fixed appliances OR=6,70, 95%CI=2,04-21,93 and combination of fixed and removable appliances OR = 5,91, 95%CI=1,89-18,46 in comparison to removable), bleeding gums during probing (OR = 4,99, 95%CI=1,92-12,97 versus non-bleeding) and the frequency of dental visits ("per 1 year" OR = 3,35, 95%CI=1,31-8,54 in comparison to the "per 6 months" visit) were positively associated with poor / moderate oral hygiene. All the above associations were found after controlling for other potential confounding factors.
In conclusion, a number of factors were found to be associated with poor oral hygiene in this sample of patients undergoing orthodontic treatment. These findings may help in identifying patients in high risk of poor oral hygiene and in implementing focused recommendations in these populations.
Orthodontic treatment, Oral hygiene, Risk factors, Brackets, Orthodontic appliances, Orthodontic patients