Patient oral hygiene is recognized as an important determinant of orthodontic treatment time and quality of the orthodontic result. Implementation of a quality oral hygiene control system, applicable to all patients, demanding little time chairside is beneficial to all orthodontic stakeholders (patient/parent, family DDS and orthodontist, and suppliers). Such a program is not isolated to patient clinical visits, but applies a common system of evaluation of patient oral hygiene in office and at home.
In applying the same standards of evaluation at home and in office, an empowered practice responsive to patient need is encouraged, which improves patient compliance.
Prior, ineffective methods of educating parents and patients to properly evaluate hygiene and enable appropriate action has resulted in practices that have complicated risk management. The proposed model combines modern risk management practices, and quality of care principles in a model of hygiene control that improves quality of care.
It is established that poor patient oral hygiene affects orthodontic treatment outcomes, impacts quality of orthodontic treatment and prolongs treatment times. 1 It has been stated that each “poor oral hygiene” entry into a patient chart relates to a 0.67 month increase in treatment time1. Reports have shown that 3 or more patient entries for “poor oral hygiene” increase treatment time by 1.2 to 2.2 months. 2 Other consequences of poor oral hygiene during orthodontic treatment affect the quality of the end result of treatment.
Orthodontic treatment with fixed appliances leads to an increased risk of enamel demineralization that is exacerbated in patients with poor oral hygiene. 3 A recent review of literature suggests that orthodontic treatment causes small detrimental effects to the periodontium. 4 The placement of fixed orthodontic appliances complicates the use of standard oral hygiene measures5 as orthodontic appliances protect the dental plaque from mechanical removal. 6 Poor oral hygiene allows significant plaque accumulation around brackets7 and subsequent white spot lesions can occur rapidly, usually on the cervical and middle thirds of the buccal surfaces of bracketed teeth. 8 Destructive processes in the periodontium are also observed in poor oral hygiene patients during orthodontic treatment as gingivitis and gingival hyperplasia. 9 The accumulation of supra-and sub-gingival plaque and the establishment of a pro-inflammatory state that leads to these destructive processes, 10 as well as increasing the potential for developing other
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Recent studies support the need to develop a new oral hygiene tracking system for orthodontists
