Introduction
The dental approach to facilitating effective tooth cleaning is necessary for all orthodontic patients, as the highest level of plaque control is required to prevent oral or dental complications. Ensuring optimal dental hygiene is paramount for orthodontic patients, as the presence of braces or aligners can make thorough cleaning more challenging. By employing specialized techniques and tools recommended by dental professionals, patients can maintain their oral health and minimize the risk of issues such as gum disease and cavities. Stay informed and proactive in the dental care journey by exploring the insights provided in the article.
What Are the Home Care Challenges Faced by Orthodontic Patients?
Home oral care can be a daily challenge for orthodontic patients with braces or brackets. This treatment often extends over months or even years until dentofacial anomalies or skeletal malocclusions are corrected. Interdental cleaning is particularly difficult for younger adults and adolescents due to tight interdental spaces, posing a challenge for maintaining periodontal health. Biofilm or plaque that forms on tooth surfaces harbors several periodontal pathogens, complicating oral hygiene for orthodontic patients wearing brackets and wires. These components hinder effective cleaning over tooth enamel and between interdental areas. Interdental brushes are less effective in reaching these areas, and handling dental floss is complicated by orthodontic wires between brackets.
What Are Some Complications Associated With Maintaining Oral Hygiene in Orthodontic Patients?
Research shows that both dental floss and traditional interdental devices, such as interdental brushes, demonstrate nearly the same efficacy in reducing the clinical parameters of gingival and periodontal disease in the oral cavity, similar to modern-day oral irrigators and powered or electric devices like flossers. However, in posterior regions, any interdental cleaning aid can prove challenging for orthodontic patients. This is because each method has its pros and cons.
It is indeed a known fact that in orthodontic patients, fixed braces can promote supra- and subgingival accumulation of plaque-based enamel biofilms. This can impede the patient's daily oral hygiene, subsequently resulting in an altered microbiota or oral environment and affecting oral immunity. Common side effects associated with most fixed orthodontic treatment modalities include gum inflammation called gingivitis and the instigation of dental caries. Hence, dental practitioners or surgeons must recommend appropriate oral hygiene measures for all patients undergoing fixed orthodontic treatment.
Similarly, the sequelae of such biofilm accumulation and improper interdental and surface cleaning can result in enamel decalcification or demineralization issues, making the patient more prone to dental caries. Gingivitis and periodontal diseases, which are common in children as well as young adolescents who are orthodontic patients, can easily occur due to difficulty in maintaining effective oral hygiene. This emphasizes the importance of dentally recommended floss, interdental devices, or oral irrigators that can aid in the near-effective elimination of dental plaque or biofilm.
How Effective Are Interdental Aids in Orthodontic Cases?
Several research studies have currently indicated that increased frequency of interdental cleaning, even by dentally healthy individuals who are not orthodontic cases, at least around four seven times per week, has been associated with fewer carious lesions, a lower incidence of periodontal disease, and significantly fewer missing teeth.
Interdental cleaning devices have several criteria that must be effectively met to preserve periodontal health. This is particularly important for orthodontic patients who may be wearing braces. Firstly, the interdental aids must be user-friendly, effective in removing dental biofilm, and easily accessible to the teeth and respective root surfaces, as well as their interproximal facets.
Most interdental aids recommended for orthodontic patients should also be considerate of the soft or hard tissues of the oral cavity, avoiding causing them trauma or harm. Although dental floss is a widely recommended interdental cleaning device, current research indicates that interdental brushes are more efficacious due to their softer bristles and ease of use compared to traditional dental floss, which many orthodontic patients may struggle to use effectively in interdental regions or handle properly.
Furthermore, compliance with dental flossing is often very low, leading many patients to fail to effectively implement flossing into their daily oral care routine. Therefore, orthodontists and dental surgeons usually prefer alternative methods for interdental cleaning compared to flossing alone. Flossing alone cannot be recommended for all sites of the teeth to preserve gingival and periodontal health, as interdental brushes may not pass through interproximal areas without causing some trauma, especially in younger patients.
Can Oral Irrigators Help in Maintaining Hygiene in Orthodontic Patients?
Although oral irrigators are presently considered reliable interdental cleaning aids and are commonly used to reduce or control biofilm and plaque on teeth, thus aiding in preventing periodontal diseases, they may not work as efficiently in orthodontic patients. Wondering why? According to current dental research, oral irrigators may not remove dental plaque or reduce gingival bleeding as effectively as traditional dental floss, even in easily accessible regions for orthodontic patients. However, in posterior regions where patients may struggle with manual dexterity (skill at doing things) or commonly have difficulty using traditional dental floss, the oral irrigator may show improved results in comparison. Oral irrigators are usually recommended only to orthodontic patients who cannot use other manual interdental brushes or who lack dexterity, such as older adults. Individuals who may not be compliant with dental flossing may also prefer oral irrigators while undergoing orthodontic treatment.
Conclusion
Hence, one can categorize orthodontic patients into two groups: those who have difficulty using oral irrigators, and those who struggle to clean interdental spaces using interdental aids and dental floss. Therefore, dentists or orthodontists should make a decision and offer the patient a choice of techniques or home care regimens to implement. It is well-known that traditional interdental brushes are the preferred device for interproximal plaque removal in orthodontic cases. However, for patients experiencing dexterity or handling issues with dental floss or interdental aids, water flossers or other oral irrigators that promote supra-gingival irrigation may be more useful.
Based on current evidence-based research in dentistry and orthodontics, oral irrigators still require significant technical improvements and customization for individual oral care regimens shortly. While oral irrigators have their drawbacks, they can indeed be a much better option, such as water flossers, for orthodontic patients struggling with interdental aid usage.
