Control of oral hygiene in the orthodontic patient: comparison between public facility and private practice

Aims. To evaluate how the application of orthodontic appliances influences the level of collaboration in the oral hygiene of the patient and whether a difference exists between patients treated in public and private structures. Methods. From April 2016 to December 2017, two hundred patients, 100 treated in the Orthodontics Department of "Sapienza" University of Rome and 100 treated in a private practice, have been evaluated for six months from the start of the treatment. All the 200 patients completed a questionnaire and an evaluation with OHI-S (Oral Health Index-Simplified) modified oral hygiene index, repeated every three months. All data have been statistically analyzed to evaluate the level of collaboration to oral hygiene and eventually present differences between public vs private structures. The differences in behavior in oral hygiene with reference to different orthodontic devices (fixed/removable) were also evaluated and the ability to maintain adequate oral hygiene with respect to the expected length of orthodontic treatment was assessed. Results. A statistically significant difference was found between the initial level of plaque index at the T0 and T1 time, found at a lower level. The maintenance of oral hygiene between public or private facilities, although the initial level was different, were eventually revealed to be not statistically different at the planned controls. There was indeed a difference between patients in treatment with fixed or removable appliances, showing a higher level of plaque deposition for the first group. Conclusions. The appropriate prescription of an oral hygiene protocol in orthodontic patients and the periodical reiteration of the message are positively correlated with an improvement of oral hygiene conditions, in spite of the sort of health facility and mainly related to the ability of the dental professionals. The presence of a fixed appliance strengthened the need for a close control.