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Tadin A, Badrov M, Mikelic Vitasovic B, Gavic L. Assessment of Motivations, Treatment Risks, and Oral Health in Adults with Fixed Orthodontic Care: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1149. [PMID: 39064578 PMCID: PMC11278680 DOI: 10.3390/medicina60071149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/07/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
Aim: This cross-sectional study aims to investigate the reasons why adults seek orthodontic treatment, their perceived treatment risks, oral hygiene habits, and awareness of oral health. Materials and Methods: This study, which involved 246 adults, used a self-report questionnaire to collect sociodemographic data and examine the participants' understanding of oral health, self-assessment of oral health status, adherence to oral hygiene routines, and use of oral hygiene products. In addition, the reasons for opting for orthodontic treatment, negative associations, and expected outcomes were examined. The collected data were subjected to statistical analysis, including descriptive and regression methods. Results: The results showed that factors such as previous oral health education and regular use of specialized toothbrushes, including rotary toothbrushes, were significantly associated with higher knowledge levels (p < 0.05). However, daily oral hygiene practices were suboptimal, with the low utilization of aids: only 58.9% reported using interdental brushes, and 36.6% used dental floss regularly. Commonly reported dental problems included food debris between teeth (46.3%), tartar (35.4%), and tooth sensitivity to cold (26.4%). The primary motivations for orthodontic treatment were aesthetic improvement (63.8%), enhancements in oral function (49.6%), and addressing psychosocial concerns (42.7%). In contrast, the most frequently mentioned negative aspects associated with fixed orthodontic treatment were aesthetic concerns (30.9%), treatment duration (27.6%), and mouth ulcers (24.0%). Conclusions: Based on the research findings, regular oral hygiene education is recommended for adult patients considering fixed orthodontic therapy, including the use of additional tools such as interdental brushes and floss to improve oral health and reduce the risk of complications during treatment. The importance of chemical compounds in dentifrices and mouthwashes cannot be overstated, as they play a crucial role in addressing various dental issues. In addition, it is crucial to carefully weigh the pros and cons of therapy and to visit a dentist regularly to maintain oral health and monitor progress during treatment.
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Affiliation(s)
- Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, University of Split School of Medicine, 21000 Split, Croatia; (A.T.); (M.B.)
- Department of Maxillofacial Surgery, Clinical Hospital Centre Split, 21000 Split, Croatia
| | - Marija Badrov
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, University of Split School of Medicine, 21000 Split, Croatia; (A.T.); (M.B.)
| | | | - Lidia Gavic
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, University of Split School of Medicine, 21000 Split, Croatia; (A.T.); (M.B.)
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Memon MA, Memon HA, Faizan-E-Muhammad, Fahad S, Siddiqui A, Lee KY, Tahir MJ, Yousaf Z. The aetiology and associations of halitosis: a systematic review. Oral Dis 2022; 29:1432-1438. [PMID: 35212093 DOI: 10.1111/odi.14172] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Halitosis is a term that refers to an unpleasant or foul odour originating from the oral cavity that can be caused by either intra-oral or extra-oral factors. Despite the fact that halitosis has multifactorial aetiology, intra-oral factors play a significant role in the majority of cases. AIM This systematic review assesses halitosis's intra-oral and extra-oral associations. METHODS An electronic search through MEDLINE (PubMed), Google Scholar, and the Wiley Online Library was conducted to identify relevant manuscripts. A keywords-based search was performed, using the terms "halitosis," "bad-breath," and "oral malodour causes and aetiology." Articles published from January 2014 to December 2020 were included. We selected studies evaluating the intra-oral and extra-oral factors that induce oral malodour, as well as the factors associated with systemic diseases. RESULTS Eighty to ninety percent of halitosis is caused by intra-oral factors, with coated tongue, periodontal diseases, and poor oral hygiene practices being the principal factors. Ten to twenty percent of halitosis is induced by extra-oral factors associated with systemic diseases. CONCLUSIONS Multiple factors can cause halitosis, but most of the aetiology is intra-oral. Increased medical awareness is needed to determine the actual pathophysiological process of oral malodour in otherwise healthy individuals.
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Affiliation(s)
| | - Hifza Anwer Memon
- Dow University of Health Sciences, Ul Ebad Institute of Oral Health Sciences, Dr. Ishrat, Karachi, Pakistan
| | | | | | - Amna Siddiqui
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Sweden
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Banjar AA, Hassan SM, Alyafi RA, Alawady SA, Alghamdi MH, Baik KM. Self-perceived halitosis among young adults undergoing orthodontic treatment. Int J Dent Hyg 2021; 20:479-486. [PMID: 34951749 DOI: 10.1111/idh.12572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Halitosis is a common oral health problem that significantly impacts the quality of life of the affected individuals. In most cases, poor oral hygiene is responsible for the problem. Orthodontic therapy aims to correct malocclusion using different devices. It has been suggested that orthodontic treatment can promote gingival health by facilitating daily oral hygiene measures. However, the treatment may harm gingival health as these appliances may lead to a more significant accumulation of plaque, increasing the microbial load in the subgingival environment leading to halitosis. OBJECTIVE The primary goal of this survey is to assess the prevalence of self-perceived halitosis in patients undergoing orthodontic treatment. MATERIALS AND METHODS An online questionnaire was randomly distributed to patients undergoing orthodontic treatment. A total of 289 subjects completed the questionnaire. It included questions about: demographic data, medical history, social habits, past dental treatment and oral hygiene habits. Descriptive statistics as frequency distributions and percentages were calculated for the study variables. RESULTS The prevalence of self-perceived halitosis was 41.5%. The majority of the participants started to notice this problem during and after orthodontic treatment (62.5%). A statistically significant correlation was found between the regular dental visits and halitosis in patients with fixed orthodontic appliances (p-value = 0.010). Also, those patients had a substantial increase in tongue coating formation (p- value = 0.010). CONCLUSION Self-perceived halitosis is a common problem in patients receiving orthodontic treatment.
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Affiliation(s)
- Arwa A Banjar
- Department of Periodontics, Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Shaymaa M Hassan
- Department of Oral medicine and periodontology, Faculty of Dentistry, Cairo University, Cario, Egypt
| | - Rusha A Alyafi
- Department of Periodontics, Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Sara A Alawady
- Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Morouj H Alghamdi
- Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Khadijah M Baik
- Prosthodontic Department, Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
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Dos Santos DDL, Besegato JF, Vieira SM, Rached Dantas AA, Silva AM, da Silva AM. Effect of fixed orthodontic appliances on self-assessment and diagnosis of halitosis in undergraduate dental students. J Indian Soc Periodontol 2021; 25:432-437. [PMID: 34667388 PMCID: PMC8452163 DOI: 10.4103/jisp.jisp_327_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/11/2020] [Accepted: 12/12/2020] [Indexed: 11/12/2022] Open
Abstract
Background: The effects of fixed orthodontic therapy on the occurrence of halitosis are not yet fully understood. This study aimed to evaluate the effect of fixed orthodontic appliances on self-assessment and diagnosis of halitosis in undergraduate dental students. Materials and Methods: Sixty-two undergraduate dental students were included in this cross-sectional study. Two groups (n = 31 per group) were composed of participants with (study group) or without (control group) fixed orthodontic appliance. Halitosis self-assessment and clinical diagnosis were assessed using a visual analogic scale (VAS) and sulfur volatile compounds (SVCs) assessment, respectively. The subjective (VAS) and objective (SVC) malodor assessments were classified in absence, light, moderate, or severe malodor. Chi-square Pearson test and Spearman's correlation were applied for data analysis, with a significance level of 5%. Results: The use of fixed orthodontic appliances had no effect on self-assessment (P = 0.490) or clinical diagnosis (P = 0.610) of halitosis. Self-assessment was not significantly associated with the diagnosis of halitosis regardless the use of fixed orthodontic appliance (P ≥ 0.737). Male participants showed higher diagnosis of halitosis (P = 0.007). SVC measurements showed the absence of halitosis in 51.6% and 58.1% of participants with or without orthodontic appliances, respectively. Conclusion: The use of fixed orthodontic appliances affected the self-assessment of halitosis but no SVC measurements. It was not verified a correlation between subjective and objective methods to diagnose halitosis in dental students.
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Affiliation(s)
| | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Sâmmea Martins Vieira
- Department of Dentistry, Faculdade Integral Diferencial - FACID/ Wyden, Teresina, PI, Brazil
| | - Andrea Abi Rached Dantas
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Aryvelto Miranda Silva
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil
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Campos Zeffa A, Dias BG, Silva DCMS, Rotta LO, Jussiani EI, Andrello AC, de Paula Ramos S. Influence of Conventional or Invisalign Orthodontic Treatment on Mineral and Trace Element Salivary Levels: Longitudinal Study with Total Reflection X-ray Fluorescence. Biol Trace Elem Res 2021; 199:2565-2572. [PMID: 32946034 DOI: 10.1007/s12011-020-02396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
This work aimed to evaluate the salivary concentration of chemical elements in patients undergoing orthodontic treatment with fixed orthodontic appliances and removable aligners. Twelve Angle Class I and II orthodontic patients undergoing treatment with conventional fixed appliances and 15 patients treated with removable aligners provided unstimulated whole saliva samples before treatment (pre) and after 3 months of treatment (post). The concentration and secretion rate of chemical elements in saliva were determined by total reflection X-ray fluorescence. Differences from pre to post and between groups were determined with the paired T test or Wilcoxon test, and two-way ANOVA, considering P < 0.05. The concentrations of S, Cl, and K decreased, while Zn increased significantly (P < 0.05) between pre and post treatment with the fixed appliance treatment. The salivary secretion rate of S was decreased from pre to post in the fixed appliance group. No differences in the concentration and secretion rate of chemical elements were detected from pre to post in the Invisalign group. Fe secretion rate presented an interaction between time and treatment, with lower secretion at post (P = 0.02) in the Invisalign group. Increased Br secretion rate and decreased Rb, Fe, P, and K in Invisalign patients suggested a better salivary electrolyte profile regarding periodontal bone remodeling. No significant alterations in ions associated with metal corrosion and inflammatory reactions were detected in orthodontic patients under dental plaque control.
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Affiliation(s)
- Aline Campos Zeffa
- Research group in Tissue Regeneration, Adaptation and Repair - State University of Londrina, Londrina, PR, 86057-970, Brazil
| | - Bianca Gonçalves Dias
- Research group in Tissue Regeneration, Adaptation and Repair - State University of Londrina, Londrina, PR, 86057-970, Brazil
| | | | | | | | | | - Solange de Paula Ramos
- Research group in Tissue Regeneration, Adaptation and Repair - State University of Londrina, Londrina, PR, 86057-970, Brazil.
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Abdulraheem S, Paulsson L, Petrén S, Sonesson M. Do fixed orthodontic appliances cause halitosis? A systematic review. BMC Oral Health 2019; 19:72. [PMID: 31046726 PMCID: PMC6498650 DOI: 10.1186/s12903-019-0761-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 04/12/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine: (I) the current evidence of the impact of fixed orthodontic appliances on the development of halitosis in patients undergoing orthodontic treatment, and (II) the influence of different orthodontic bracket systems on halitosis. MATERIAL AND METHODS Three electronic databases (PubMed, Scopus, and Cochrane Library) were searched prior to March 15, 2018. The review was systematically conducted and reported according to the Cochrane Handbook and the PRISMA statement. Only Randomised Clinical Trials (RCTs) were considered. Selected full-text papers were independently assessed by four investigators and any disagreements were resolved by consensus. The Cochrane Handbook was used to grade the risk of bias and the quality of evidence was rated according to GRADE. RESULTS Out of 363 identified studies, three RCTs on halitosis and fixed orthodontic appliances met the inclusion criteria. The risk of bias in the three studies was rated as high and the quality of evidence was rated as very low. CONCLUSIONS/CLINICAL IMPLICATIONS There is a lack of scientific evidence that subjects with fixed orthodontic appliances develop halitosis during treatment. Additional well-conducted RCTs with extended periods of assessment are needed as well as consensus concerning cut-off values for the diagnosis of halitosis.
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Affiliation(s)
- Salem Abdulraheem
- Department of Orthodontics, Faculty of Odontology, Malmö University, SE-20506, Malmö, Sweden.
- Ministry of Health, Kuwait City, Kuwait.
| | - Liselotte Paulsson
- Department of Orthodontics, Faculty of Odontology, Malmö University, SE-20506, Malmö, Sweden
| | - Sofia Petrén
- Department of Orthodontics, Faculty of Odontology, Malmö University, SE-20506, Malmö, Sweden
| | - Mikael Sonesson
- Department of Orthodontics, Faculty of Odontology, Malmö University, SE-20506, Malmö, Sweden
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Effect of rapid maxillary expansion on halitosis. Am J Orthod Dentofacial Orthop 2018; 154:702-707. [PMID: 30384941 DOI: 10.1016/j.ajodo.2018.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate the effect of rapid maxillary expansion (RME) on halitosis. METHODS Thirty children (11-15 years old) were randomly divided into RME and control groups. The RME group consisted of 15 children treated with hyrax appliances, and the control group included 15 children without treatment. Halitosis was evaluated with the halimeter and the organoleptic method. Plaque index and gingival index scores were recorded. Acoustic rhinometry was used to measure the nasal volume. Measurements were obtained at 2 times: before RME, and after retention at 4 months. The Wilcoxon signed rank test and the paired t test were used for intragroup comparisons, and the Mann-Whitney U test and the Student t test were used for intergroup comparisons. RESULTS Halitosis (halimeter and organoleptic values) decreased significantly in the RME group (P <0.001). Insignificant changes of halitosis were observed in the control group. Intragroup and intergroup comparisons showed no statistically significant differences for the plaque index. Gingival index values were significantly decreased with RME (P ≤0.05). Nasal cavity volume increased significantly in the RME group (P <0.01). CONCLUSIONS RME was shown to lower halitosis values. RME could be a treatment option for patients with maxillary transverse deficiency and halitosis.
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Huang J, Li CY, Jiang JH. Effects of fixed orthodontic brackets on oral malodor: A systematic review and meta-analysis according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Medicine (Baltimore) 2018; 97:e0233. [PMID: 29620635 PMCID: PMC5902289 DOI: 10.1097/md.0000000000010233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND This systematic review and meta-analysis aimed to identify whether there is any relationship between fixed orthodontic appliances and malodor, and if self-ligating brackets (SLBs) prevent malodor better than conventional brackets (CBs). METHODS The electronic databases PubMed, Ovid, EMBASE, and the Cochrane Library were searched from inception to September 2016; a manual search was also performed. Randomized controlled and clinical controlled trials, in which experimental groups received fixed orthodontic therapy and malodor was measured, were included. Patients treated with fixed orthodontic brackets were compared with those without any treatment, and SLB systems were compared with CB systems. Two reviewers independently selected potentially relevant studies, evaluated the risk for bias, extracted essential data, and synthesized findings using Review Manager version 5.3 (Copenhagen: The. Nordic Cochrane Centre, The Cochrane Collaboration, 2014). RESULTS Four studies, involving a total of 152 participants, met the inclusion criteria. Fixed orthodontic appliances caused malodor from the initial visit to 2 to 3 months, but was only significant after the first week (mean difference 20.24 [95% confidence interval [CI]11.75-28.74]; P < .00001). Plaque index, gingival index, and periodontal pocket depths demonstrated no statistical differences between the SLB and CB groups after the first week. However, SLBs significantly controlled malodor better than CBs after the first week (mean difference 4.32 [95% CI 6.02 to 2.61]; P < .00001). The quality of the included studies was relatively low and relevant research in this field is quite scarce. CONCLUSIONS Although the evidence base was relatively weak, fixed orthodontic treatment appeared to be a risk factor for malodor, independent of periodontal changes, and SLB systems controlled malodor better than CB systems.
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Affiliation(s)
| | - Cui-Ying Li
- Central Laboratory, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
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