The value of mouthwash

It is well recognised that fixed orthodontic appliances are considered to be a clinical risk factor for demineralisation of enamel because of plaque accumulation around the bracket base.

According to Tufekci et al, published in The angle orthodontist, ‘the development of white spot lesions during orthodontic treatment is almost inevitable when oral hygiene is poor’.  Demineralisation is more commonly seen on the buccal surfaces of orthodontically treated teeth than on untreated teeth.  This is due to prolonged plaque retention around the brackets.  The development of gingivitis and hyperplastic gingiva is also a well recognised problem during orthodontic treatment with fixed appliances.

Metallic brackets have been found to involve specific changes in the oral environment, such as decreases in pH and increases in plaque accumulation that further increase the risk of demineralisation.

According to Beyth et al, successful orthodontic treatment requires high compliance, especially by teenagers, whose compliance is generally low.  The ability of the orthodontist to continuously monitor patients’ oral hygiene is limited.  Monitoring the oral state is particularly important in certain patients such as those who are handicapped, those who have undergone dental surgery, young children (in early mixed dentition), and those with many (before orthodontic treatment) filled and decayed teeth.  Failure to maintain proper oral hygiene leads to tooth damage, consequently affecting the orthodontic treatment.