Effect of Intraoral Appliance on Oral Health Status and Streptococcus mutans Count: A Longitudinal Study

Abstract

Abstract Objective Appliances used in preventive and interceptive orthodontics, which are often provided to correct or intercept a specific malocclusion or habit, may be detrimental. to a child's oral health. The objective of this study was to evaluate the effect of intra oral appliance wear on the plaque index, gingival index, bleeding on probing, and on levels of salivary Streptococcus mutans. Materials and Methods A total of 60 children requiring any preventive or interceptive orthodontic treatment (appliance therapy) were randomly divided into two groups, as fixed orthodontic appliance group (n = 30) and removable appliance group (n = 30). Preoperative and post operative assessments of patients were done before and after wearing appliances. Assessment was done by determining oral hygiene status and microbiological evaluation of saliva for S. mutans count. S. mutans colonies were counted from saliva cultured on mitis-salivarius-bacitracin (MSB) agar. Statistical Analysis Data that are continuous in nature were summarized as standard deviation and mean. For “within group” comparisons, paired t-tests were used to analyze the continuous data. For “between group” comparisons, unpaired t-tests and Fisher's exact test were used to analyze the continuous data. Results Appliance treatment increases plaque and gingival indices. Plaque and gingival index changes 1 month after deployment of both fixed and removable appliances were essentially the same and statistically non-significant with p-values of 0.412 and 0.965. Bleeding on probing after insertion of both appliances was not statistically significant (p=0.423). S. mutans numbers increased following removable and fixed orthodontics. Fixed appliances had more S. mutans than removable appliances (p=0.014). Conclusion The inherent levels of these microorganisms are related with plaque accumulation due to fixed or removable appliances. Increase in the level of plaque and microorganisms after fixed and removable appliance therapy can hamper optimum oral health and thus is a concern for pedodontists. During orthodontic therapy, cariogenic pathogens should be reviewed, and to prevent cariogenic pathogens from increasing and to maintain oral hygiene during orthodontic treatment, proper recall visits, patient and parent education, and regular fluoride application are essential.