In the oral cavity, a specific environment for microorganisms is created by various physical, chemical and biological factors.
Treatment of mal occlusion with fixed braces disturbs the natural oral environment. The various components of the appliance impede the flow of saliva, which naturally cleans the surface of the teeth or gums.
Observations have been made on the increase in the number of microorganisms in the oral cav ity after the fitting of fixed braces. An increase in Lactobacillusacidophilus by 3.5% and Streptococcusmutans was recorded. These are bacteria that contribute to caries formation. The metal components of the appliance promote fungal growth. Another study found that almost 50% of patients treated with fixed braces, despite the use of fluoride toothpastes, develop white carious spots, most often in the fossa area of the vestibular surface of the upper incisors and on the mandibular molars. This is probably related to the site of saliva flow.
One study was conducted on a group of 60 patients who had been receiving orthodontic treatment for 16 months. All subjects had full permanent dentition. The first group of 30 included patients treated with thin arch braces on one dental arch and the second group, also 30 patients, included patients treated with thin arch braces on both dental arches. The control group comprised 30 patients with no orthodontic treatment. The severity of the caries process was assessed on the basis of the PUW index. Its mean value in individual groups was: - group one- 4.97, - group two- 5.60, - control group- 4.5.
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No difference in caries severity was observed between boys and girls. The CRT test was also used to determine the severity of caries. This test assesses the number of bacteria that initiate and exacerbate the carious process: Streptococcus mutansi Lactobacillus acidophilus. It was found that people undergoing orthodontic treatment had a much higher number of colonies of the above microorganisms than those in the control group.
The high level of carious bacteria in the mouth of patients treated with fixed braces necessitates frequent oral hygiene checks. It is also advisable to use a wide range of preparations intended for oral care and hygiene for people undergoing orthodontic treatment with fixed braces.