Factors affecting demineralization during orthodontic treatment: A post-hoc analysis of RCT recruits

Introduction: Our aim was to determine predictors for the presence and degree of demineralization during orthodontic treatment. This study was a post-hoc analysis of recruits for a randomized controlled trial. Two hundred thirty patients were included in this study and assessed for demineralization at debond by using quantitative light-induced fluorescence to determine their eligibility for a randomized controlled trial assessing the effectiveness of various toothpastes at reducing demineralization during retention. Methods: Data about patients' demographics, treatments, oral hygiene, and pretreatment status of the first permanent molars were extracted from case notes. Data on the presence and severity of white spot lesions (WSLs) were obtained from the trial's data base. Univariate analyses and multiple regression were undertaken to assess for associations between the factors and the presence and severity of WSLs. Results: Sixty-five patients (28.3%) had no WSLs, and 165 (71.7%) had 1 to 12. The mean number of WSLs per patient with demineralization was 2.9 (95% CI, 2.5 and 3.3). Patients with WSLs were significantly (P = 0.002) younger and more likely to have diseased first molars (P = 0.04). Participants with inadequate pretreatment oral hygiene developed more WSLs (P = 0.03). Boys (P = 0.001) and participants with diseased first molars (P = 0.06) had significantly greater demineralization. Conclusions: Sex, pretreatment age, oral hygiene, and clinical status of the first molars can be used as predictors for the development and severity of WSLs during orthodontic treatment. (Am J Orthod Dentofacial Orthop 2011;139:181-91)