Orthodontists' instructions for oral hygiene in patients with removable and fixed orthodontic appliances

Int J Dent Hyg. 2024 May;22(2):329-336. doi: 10.1111/idh.12763. Epub 2023 Oct 16.

Abstract

Introduction: The aim of this questionnaire-based survey was to evaluate information on frequencies, instructions and products relating to oral hygiene (OH) in orthodontic practices.

Methods: Using a computer-generated randomization list, 1000 orthodontists were selected and sent a questionnaire. The size and number of inhabitants of the federal states of Germany were considered. The federal states with the highest return rate (Baden-Wuerttemberg [BW], Bavaria [B], Hesse [H], Lower Saxony [LS], Nordrhein-Westphalia [NRW]) were considered and differences between the 16 federal states were divided into North, South, East and Central Germany.

Results: The response rate of the questionnaires was 52.4%. The majority (53.8%) worked in one practice alone. Most (59.1%) have been orthodontists for 5-25 years. For vestibular multibracket appliances (MBA) in BW, B, H and LS over 90% recommended interdental brushes (IDB). In NRW 91.4% recommend fluoride gel. In B and H more than 80% chose electric toothbrush (ETB), in BW, LS and NRW more than 80% manual toothbrush (MTB). For lingual MBA (LMBA) in BW, H, LS and NRW with approximately 50% each fluoride gel, IDB and MTB were chosen. In B fluoride gel, IDB and ETB. For removable apparatus (RA), five federal states recommended MTB (>80%) and ETB (BW, B, H > 80%; NRW > 70%; LS > 60%).

Conclusion: Electric toothbrushes are recommended for the use with all appliances, only with removable appliances manual toothbrushes are favoured. For vestibular MBA it is strongly advised to use IDB additionally.

Keywords: Electric toothbrush; interdental brushes; multibracket appliances; oral hygiene; questionnaire study; removable appliances; white spot lesions.

MeSH terms

  • Fluorides
  • Humans
  • Oral Hygiene*
  • Orthodontic Appliances
  • Orthodontic Appliances, Fixed
  • Orthodontists*
  • Toothbrushing

Substances

  • Fluorides