| |
Objective: Investigate the effect of caries risk factors like oral hygiene, socio-economic status, gender and treatment duration on the prevalence of caries lesions at debonding in orthodontic patients wearing fixed appliances. Methods: The buccal surfaces of 62 orthodontic patients, 29 males and 33 females, who had worn fixed appliances for at least one year, were examined with LF for the presence or absence of initial caries lesions at debonding. Lactobacilli and Mutans Streptococci counts just prior to debonding as well as 6 weeks thereafter were obtained using a CRT-dipslide test. At these exams also the bleeding score was determined. Socio-economic status, gender, treatment duration and dietary habits were determined using a questionnaire and food-diary. Results: The prevalence of caries was high; 97% of the subjects and on average 30% (SD 23%) of the buccal surfaces in a person were affected. A significant difference between % of affected surfaces in males (40%) and females (22%, p<0.01) was found. A positive correlation was found between the bleeding score (r = 0.4, p<0.01), Lactobacilli counts (r = 0.4, p<0.01) and the caries prevalence just prior to debonding. Mutans Streptococci counts were high (>105 CFU) at debonding regardless of the caries prevalence. Six weeks after debonding the bleeding scores, Lactobacilli and Mutans Streptococci counts were reduced and any correlation with caries prevalence was lost. Caries prevalence was not influenced by age, treatment duration, socio-economic status or dietary habits. Conclusion: The traditional caries risk factors did not explain the incidence of white spot lesions in orthodontic patients. Lactobacilli counts prevailed over Streptococci counts to identify orthodontic patients at risk, indicating that the traditional known balance in the mouth is changed. Determination of bleeding scores and lactobacilli counts in addition to visual inspection during the orthodontic treatment may indicate individuals at increased risk for developing caries. |