Effective Tooth Brushing Technique to Manage Periodontal Diseases in Orthodontic Patients: A Double-Blind Randomized Controlled Trial

Introduction: Orthodontic treatment can cause difficulties in maintaining good oral hygiene leading to the accumulation of dental plaque, gingival inflammation, periodontal disease, and caries. This study aimed to evaluate the efficacy of three different tooth brushing techniques on the prevention of periodontal diseases in patients with fixed orthodontics treatment. Materials and Methods: In this parallel-group, double-blind randomized controlled trial, 57 patients undergoing fixed orthodontic treatment with mild gingivitis were randomly divided into three groups (scrub, modified Stillman, and modified bass) using a simple randomization technique. The patients were instructed to brush their teeth three times a day and to floss once a day. Gingival (Silness and Loe) and plaque indices (O’Leary and Quickly hein) were recorded at baseline, after 2 weeks and after 3 months. ANOVA and Post Hoc tests were used; otherwise, Kruskal-Wallis test and Post Hoc tests were used in SPSS 24. The significance level was set at p>0.05. Results: Gingival index and plaque indices (Quickly hein and O-Leary) significantly decreased when using 3 methods of tooth brushing (respectively p>0.001, p˂0.05 and p>0.001). However, age and gender had no statistically significant relationship with recorded periodontal parameters in the three groups of subjects. Conclusion: All three studied methods were effective in the reduction of gingival and plaque indices in patients undergoing orthodontic treatment.