Caries Risk Factors in Children under Treatment with Sectional Brackets

Objective: To longitudinally investigate the caries risk levels in children undergoing orthodontic treatment with sectional brackets. Materials and Methods: A total of 42 children scheduled for orthodontic treatment with sectional orthodontic appliances participated in this study. They were divided into two groups based on decayed, missing, and filled permanent and deciduous teeth (DMFT/dmft) scores and counts of mutans streptococci (MS) prior to treatment. One was the low caries risk group (n = 26) and the other was the high caries risk group (n = 16). Paraffin-stimulated whole saliva was collected for examination of salivary flow rate, buffer capacity, and MS and lactobacilli (LB) levels before treatment, 2 and 4 months after appliance placement, and 2, 4, and 8 months after appliance removal. Results: The pretreatment salivary flow rates, buffer capacity, and MS levels remained statistically unchanged during and after active orthodontic treatment in both groups. The levels of LB in the high caries risk group were significantly elevated by appliance placement, but upon appliance removal started to fall significantly and came a little short of the pretreatment levels. In the low caries risk group, the pretreatment levels of LB remained statistically unchanged during and after treatment. There were no significant differences in salivary flow rate or buffer capacity, but there were significant differences in MS and LB scores between the two groups at every measurement time. Conclusions: In children undergoing orthodontic treatment with sectional brackets, LB levels are an important part in making caries risk assessment. (Angle Orthod. 2010;80:509-514.)