The effectiveness of caries prevention in patients with enamel defects of noncarious origin at the stages of orthodontic treatment

Abstract

BACKGROUND: White spot caries around braces is a common complication of orthodontic treatment. Numerous studies have indicated varying levels of the effectiveness of preventive measures for patients with braces, particularly for patients with noncarious enamel defects.

AIM: This study aimed to determine the effectiveness of the use of preventive agents around braces and in the area of noncarious spots in patients with enamel defects at the stages of orthodontic treatment.

MATERIALS AND METHODS: The study involved 54 patients aged 14–18 years. All patients were divided into three groups. In group 1, patients were treated monthly with the area around the bracket and the spot with Fluorine-Lux for deep fluoridation. In group 2, the enamel around the braces was fluoridated monthly with Fluorine-Lux varnish. Patients used R.O.C.S. toothpaste for home hygiene (ProBrackets&Ortho). In group 3 (control group), patients received professional oral care twice a year according to the standard regimen. Patients used fluoride toothpaste for oral care at home. Treatment lasted no more than 25 months. The initial levels of hygiene, caries intensity, and enamel resistance in all groups were comparable.

RESULTS: After removing the bracket system, the intensity of the caries in group 1 significantly increased slightly to 13.75 ± 1.12 (p > 0.01), and the “K” component increased to 2.91 ± 0.38 (p > 0.01). After removing the orthodontic equipment, the intensity of the carious process in group 2 was 12.23 ± 1.34, with highly significant differences (p < 0.05), the “K” component was 3.42 ± 0.19 (p < 0.05), and the number of teeth with noncarious defects was 4.19 ± 0.06 (p < 0.05). The appearance of new carious spots and cavity defects in teeth with noncarious enamel lesions that require treatment and filling were recorded. In group 3, the intensity of dental caries after the removal of the orthodontic equipment was 18.21 ± 0.16, with highly significant differences (p < 0.05), the “K” component was 6.83 ± 0.11 (p < 0.05), and the number of teeth with noncarious defects was 1.98 ± 0.04 (p < 0.05). The appearance of new carious spots and cavity defects in teeth with noncarious enamel lesions requiring treatment and filling were registered.

CONCLUSIONS: To prevent caries in the form of white spots on the teeth in patients with noncarious lesions during orthodontic treatment, professional oral hygiene monthly with the removal of the arch wire is recommended. The most effective is the combination of home oral hygiene using calcium-containing paste and monthly application of the drug Fluorine-Lux for deep fluoridation around braces and in noncarious areas.

Keywords

caries prevention / suspenders / orthodontic treatment / white enamel spots / enamel defects / deep fluoridation

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