Does oral health promotion influence the oral hygiene and gingival health of patients undergoing fixed appliance orthodontic treatment? A systematic literature review.
OBJECTIVE
To determine the effectiveness of orthodontic oral health promotion (OHP) upon gingival health.


METHODS
The Cochrane Central Register of Controlled Trials [CENTRAL (January 2005)], MEDLINE [OVID and PubMed platforms (1966 to May 2005)] and EMBASE (1966 to May 2005) were searched. A grey literature search was also conducted.


METHODS
Of the 218 studies identified, 37 were retrieved for detailed examination. Methodological quality was determined using a checklist and inter-rater reliability was calculated using the unweighted kappa statistic. Six randomised (RCT) and quasi-randomised controlled clinical trails (CCT) met the inclusion criteria.


METHODS
Categorical data about the effect of oral health promotion on dental plaque levels and/or gingival bleeding were independently collected from the four RCTs and two CCTs by two reviewers using a data extraction proforma.


RESULTS
Positive effects on plaque and/or gingival health were produced in only four of the included trials. OHP resulted in no difference being detected in two of the included trials. None of the trials that were included produced a negative effect of orthodontic oral health promotion on oral hygiene and gingival health. Direct comparison between the trials was difficult due to the heterogeneity in the outcome measures between the included studies.


CONCLUSIONS
An OHP programme for patients undergoing fixed appliance orthodontic treatment produces a short-term reduction (up to 5 months) in plaque and improvement in gingival health No particular OHP method produces a greater short term benefit to periodontal health during fixed appliance orthodontic treatment Further studies using appropriate methods and in particular longer follow up periods are required.
Gray
Darren
D
Dundee Dental Hospital & School, Dundee, Tayside, UK.
McIntyre
Grant
G
D003773:Dental Plaque / Q000209:etiology / Q000517:prevention & control*; D005882:Gingival Diseases / Q000209:etiology / Q000517:prevention & control; D006267:Health Education, Dental / Q000379:methods*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D009910:Oral Hygiene; D009967:Orthodontic Appliances / Q000009:adverse effects*; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic