Oral Health Changes During Fixed Orthodontic Treatment: A Longitudinal Assessment

Background: Good oral health is essential during fixed orthodontic treatment, as brackets, bands, and archwires alter the oral environment. These appliances promote plaque retention and make oral hygiene more difficult, increasing the risk of gingival inflammation and periodontal complications. If not controlled, these changes may negatively affect oral health and orthodontic outcomes. Therefore, monitoring oral hygiene and gingival status during treatment is clinically important.

Aim: To evaluate changes in gingival health and plaque accumulation during early fixed orthodontic treatment.

Materials and Methods: A total of 30 patients undergoing fixed orthodontic treatment at the Aldent University Clinic were included. Gingival health was assessed at baseline (T0), one month after appliance placement (T1), and three months after placement (T2). Plaque accumulation and gingival status were measured using the Orthodontic Plaque Index (OPI) and Gingival Index (GI). Statistical analysis was performed using IBM SPSS Statistics version 21.0. Associations between categorical variables were tested using the Chi-square test and Fisher’s Exact test, with significance set at p < 0.05.

Results: Plaque accumulation increased significantly after appliance placement, with higher OPI scores at T1 and T2 compared to T0. Gingival inflammation also increased significantly during the first month and remained elevated at T2. A statistically significant association was found between gender and oral hygiene status (χ²(1)=6.58, p=0.010; Fisher’s Exact Test p=0.016), with females demonstrating better oral hygiene than males.

Conclusion: Fixed orthodontic treatment was associated with increased plaque accumulation and a significant rise in gingival inflammation during the first month after appliance placement. Female patients showed better oral hygiene than males. These findings highlight the importance of early and continuous oral hygiene instruction and regular professional monitoring to prevent periodontal complications and maintain gingival health during orthodontic treatment.