The effect of fixed appliances on oral malodor from beginning of treatment till 1 year

Abstract

BackgroundOrthodontic appliances can enhance plaque accumulation, and this can cause gingival inflammation. Halitosis of oral origin is associated with microbial metabolism on the tongue and in the saliva, dental plaque, and the amount of volatile sulfide-containing compounds. This study used a Halimeter to investigate fixed orthodontic therapy-associated increases in the oral malodor over a year.MethodsThirteen orthodontic patients with Angle Class I malocclusions receiving fixed orthodontic therapy formed the study group, and 12 dental students without any dental treatment formed the control group. The Halimeter was used to examine oral malodor by detecting volatile sulfur compounds (VSC). Plaque index (PI), gingival index (GI), and probing pocket depth (PPD) were also measured in both groups. The subjects in the study group had one visit before the orthodontic treatment started and seven visits during orthodontic therapy (1, 3, 5, 7, 9, 11, and 13 months after bonding), while the subjects in the control group had three visits, once per subsequent month.ResultsOral malodor was significantly increased in the fixed orthodontic treatment group during treatment (p < .05). Increases were also observed in the PI, GI, and PPD measures (p < .05). The results of the control group were stable (p > .05).ConclusionOral malodor increased during fixed orthodontic treatments and reached a critical level 7 months later.

Effectiveness of tongue scraper in reducing halitosis in orthodontic patients: a clinical study

“…14 After 27 days, the oral malodor scores had significantly decreased compared to the baseline, although the clinical study indicated an increase after the braces were applied. 3,13 This disparity may be explained by the variability of oral hygiene methodology, considering that the participants were adolescents. Adolescents need a unique approach to be motivated about their oral health issues, which are substantially associated with their social interactions.…”

“…11 Although some studies have shown a lower occurrence of oral malodor in patients with self-ligating brackets compared to patients using conventional brackets, 12 other studies have indicated that self-ligating brackets have a higher potential for bacterial accumulation. 13 Overall, fixed orthodontic therapy interferes with the occurrence of oral malodor due to elevated levels of bleeding, gingival inflammation and the presence of periodontal pockets. 13 With this reasoning, studies have focused on exploring the oral malodor etiopathogeny in fixed-orthodontic users, in order to determine their particularities and, consequently, conduct an appropriate control.…”

“…13 Overall, fixed orthodontic therapy interferes with the occurrence of oral malodor due to elevated levels of bleeding, gingival inflammation and the presence of periodontal pockets. 13 With this reasoning, studies have focused on exploring the oral malodor etiopathogeny in fixed-orthodontic users, in order to determine their particularities and, consequently, conduct an appropriate control.…”

Effects of fixed orthodontic brackets on oral malodor

“…Zurfluh et al [ 21 ] found significant differences in organoleptic measurements on the same subjects between the initial visit and at 3 months. Based on a 1-year observation, Sokucu et al [ 12 ] reported that oral malodor in orthodontic patients reached a peak after 7 months and stopped increasing during the ninth month of treatment.…”

“…Recently, some investigators have reported that fixed orthodontic appliances can increase oral malodor, [ 11 , 12 ] and that oral malodor should be regarded as one of potential side effects of orthodontic treatments. Additionally, the effects of self-ligating bracket (SLB) and conventional bracket (CB) systems have been discussed widely, although a previous meta-analysis revealed that SLBs do not outperform CBs in promoting oral health.…”