The incidence of caries and white spot lesions in orthodontically treated adolescents with a comprehensive caries prophylactic regimen--a prospective study

Abstract

The aim of the study was to assess the effect of a comprehensive prophylactic regimen in reducing the incidence of white spot lesions (WSL) and caries during orthodontic treatment. Eighty consecutive patients, scheduled for fixed appliance treatment in both jaws were compared with a non-orthodontic matched-control group. The oral hygiene regimen consisted of brushing two to three times daily, flossing, fluoride rinse, and plaque disclosing tablets. Patients were requested to avoid carbonated soft drinks/acidic juices and candies. The WSL index of Gorelick et al. (Gorelick L, Geiger A M, Gwinnett A J 1982 Incidence of white spot formation after bonding and banding. American Journal of Orthodontics 81: 93-98) was used. Caries were scored according to Amarante et al. (Amarante E, Raadal M, Espelid I 1998 Impact of diagnostic criteria on the prevalence of dental caries in Norwegian children aged 5, 12 and 18 years. Community Dental Oral Epidemiology 26: 87-94). We collected data from all finished cases. It comprised 40 subjects in the orthodontic group (mean age: 13.6 years, range: 12-16 years) and 40 matched controls. The average treatment time was 18 months (range: 9-25 months). The mean increase in WSL index in the orthodontic group was 1.9 and 0.4 in the control group (P = 0.001). The mean increase in dentine caries was 0.5 lesions and 0.7 lesions in the in the orthodontic group and control group, respectively (P = 0.62). Twenty-three per cent of treated patients showed good compliance, 68 per cent moderate compliance, and 9 per cent poor compliance. The mean increase in WSL was 1.0, 1.4, and 3.3 in the good, moderate, and poor compliance group, respectively (P = 0.155). Orthodontically treated patients have significantly higher risk for developing WSL than untreated patients, while there is no difference with respect to development of new dentinal caries lesions. This study showed that a possible relationship between compliance and WSL development existed.

Antiadherence and Antimicrobial Properties of Silver Nanoparticles against Streptococcus mutans on Brackets and Wires Used for Orthodontic Treatments

“…The dental caries starts commonly its demineralization process on the dental enamel surfaces presenting opaque and white colors called to this stage as a white spot lesion (WSL) [2]. The development of WSLs is generally associated to prolonged dental plaque accumulation on the dental surfaces [3] and factors like diet, deficiency in calcium, phosphate, fluoride, and bicarbonate levels; specific medical and dental as well as genetic characteristics might be involved [3,4]. Streptococcus mutans (S. mutans) has been considered the principal oral pathogen involved in the development of dental caries [5]; however, these bacteria have also been associated with other systemic diseases, such as bacteremia and infective endocarditis because of its great ability of the bacteria to adhere to tooth surfaces [6,7].…”

Caries infiltrant combined with conventional adhesives for sealing sound enamel in vitro

“…2 Prevalence of these acquired surface lesions due to orthodontic treatment, so-called white spot lesions (WSL), is relatively high, affecting more than 40% to 60% of the patients. 3,4 They can appear very rapidly, as fast as in a couple of weeks after the placement of brackets. 5 The efficacy of preventive measures against this phenomenon has been questioned during the last two decades.…”

Effects of different orthodontic primers on enamel demineralization around orthodontic brackets

“…Because of the changes in light scattering of the porous enamel, demineralized areas obtain a white appearance and manifest themselves as white spot lesions (WSLs) or demineralization. Compared to a matched control sample, these lesions were observed in 60% of orthodontic patients and in 6.7% of their teeth, although a comprehensive caries prophylactic regimen was strictly followed in these patients [13].…”

“…Aufgrund der veränder-ten Lichtstreuung durch porösen Schmelz bekommen demineralisierte Flächen ein weißes Erscheinungsbild und manifestieren sich als White-Spot-Läsionen (WSL). Trotz strenger und umfassender Kariesprophylaxe wurden solche Läsionen im Vergleich zu einer angeglichenen Kontrollgruppe bei 60% der kieferorthopädischen Patienten an 6,7% ihrer Zähne beschrieben [13].…”