Download plaque score during orthodontic treatment in relation to age and

ORIGINAL ARTICLE
PLAQUE SCORE DURING ORTHODONTIC TREATMENT
IN RELATION TO AGE AND GENDER
Abdul Bari Memon1
BDS, MSc
2
Abdul Jabbar
BDS, FCPS
Irfan Ahmed Shaikh
3
Waheed Murad Dahri4
5
Permanand Malhi
Sadam Hussain Rind
BDS, FCPS
BDS
BDS, MSc
6
BDS
OBJECTIVE: Aim of our research was to assess the plaque score in the orthodontic patients in relation to gender,
age and duration of orthodontic treatment.
METHODOLOGY: A cross sectional study was conducted at the Department of Orthodontics, Liaquat Medical
University Hospital, Jamshoro and private orthodontic clinics in Hyderabad. Included subjects were asked to chew
the plaque disclosing tablet. Turseky modification of Quigley Hein Plaque index was used to calculate plaque score.
Selected patients were asked to fill the questionnaire regarding plaque control measures.
RESULTS: Mean plaque score was 4.29+1.58. Mean values of plaque for male and female were 2.42+0.70 and
2.51+1.99 respectively, this difference was statistically insignificant. Most of the patients were cleaning their teeth
once a day and few were cleaning thrice a day. ANOVA showed insignificant differences in plaque score and
duration of fixed appliance. There was insignificant (r=0.035, p =0.581) correlation between age and plaque score.
CONCLUSION: It was concluded that, plaque score was not influenced by gender, age or duration of fixed
orthodontic treatment.
KEY WORDS: Plaque index, orthodontic fixed appliances.
HOW TO CITE: Memon AB, Jabbar A, Shaikh IA, Dahri WA, Malhi P, Rind SH. Plaque Score During Orthodontic
Treatment in Relation to Age and Gender. J Pak Dent Assoc 2015; 24(2):100-103.
INTRODUCTION
I
t is important to maintain better oral hygiene during
orthodontic treatment. Fixed orthodontic appliances
cause difficulty in tooth brushing which lead to
accumulation of plaque. Emphasis must be given on oral
hygiene maintenance, including both professional tooth
1. PhD Scholar, Medical Research Center, Liaquat University of Medical & Health
Sciences Jamshoro Sindh.
2. Assistant professor, Liaquat University of medical and Health Sciences Jamshoro
Cell: +92-333-2608489
3. Assistant Professor, Isra Dental College Hyderabad Sindh.
Email: [email protected]
4. Lecturer, Bhittai Medical and Dental College Mirpurkhas Sindh.
Email: [email protected]
5. Assistant Professor, Bhittai Medical and Dental College Mirpurkhas Sindh.
Email: [email protected]
6. Post graduate trainee, Liaquat University of medical and Health Sciences Jamshoro
Email: [email protected]
Corresponding author: “Dr Ahmed Bari Memon ” < [email protected] >
JPDA Vol. 24 No. 02 Apr-June 2015
cleaning and home care instructions1-3.
There is direct correlation between oral hygiene and
periodontal health4. Orthodontic appliances such as brackets
and bands trap food and other debris under wir e which
makes it challenging for patient to maintain oral hygiene5.
Good oral hygiene is hallmark for good dental and
periodontal health during orthodontic treatment6-8. Brackets,
arch wires and other orthodontic gadgets are main focal
points for accumulation of plaque and also acts as obstacle
to control the plaque hence enhancing gingivitis9. Plaque
also carries cariogenic bacteria which are capable of
developing white spot lesions around brackets margins7,8.
Fixed orthodontic treatment increases risk of enamel
demineralization which is evident in patients with
compromised oral hygiene10.
A recent review of literature concluded that fixed
orthodontic treatment may cause few detrimental effects
100
Memon AB / Jabbar A / Shaikh IA /
Dahri WA / Malhi P / Rind SH
Plaque Score During Orthodontic Treatment in Relation
to the periodontium11. Along with that in another study it
is also stated that periodontitis due to orthodontic fixed
appliance therapy may be avoided if basic oral hygiene
maintenance protocol is followed12. It is observed that a
significant percentage of orthodontic patients feel difficulty
in maintaining oral hygiene and exhibit adverse effects13.
Tooth brushing is the principal tool used for plaque
control, however regular tooth brush does not remove
inter-dental plaque adequetly14. Therefore inter-dental
plaque controlling aids such as flossing and inter-dental
brushing should be added along with regular brush. Oral
hygiene instructions are frequently demonstrated by
orthodontists to their patients routinely to motivate them
for oral hygiene improvement15. Aim of our research was
to assess the plaque score in the fixed orthodontic patients
in relation to gender, age and duration of orthodontic
treatment.
METHODOLOGY
A cross sectional study was conducted from spetember
2013 to march 2014 at the Department of Orthodontics,
Liaquat Medical University Hospital and private
orthodontic clinics in Hyderabad. Permission was obtained
from the ethical review committee and informed written
consent was taken from all participants.
The online Epi calculator was used to calculate sample
size. The sample size was calculated at a 95% confidence
interval, with 0.3% estimated proportion of plaque and
0.05 desired precision of estimate from the 1000 population
size. The required sample size was 245.
Non-probability purposive sampling technique was
used to select 245 orthodontic patients. Orthodontics
patients having fixed orthodontics appliances, age ranges
from 13 to 25 years of either gender, permanent dentition
up to 2nd molar, having no enamel defects or no restorations
involving facial surface and good general health were
included in study. Patients having crown, bridge, removable
appliances or clear liners and mouth washes used in last
four weeks were excluded from study.
Mouth mirror and profound light were used to examine
patients individually. Selected patients were asked to chew
the plaque disclosing tablet (Eviplac Pastilhas), swish it
for thirty seconds, spit out and wash once with clean water
to decrease the false positive results. Facial, palatal and
lingual surfaces were examined to calculate the plaque
score. Turseky modification of Quigley Hein Plaque index
was used to calculate plaque score using the following
formulae:
Index = Total score / number of surfaces Examined
The data was analyzed by Statistical Package for Social
Sciences (SPSS) version 16. Categorical variables like
gender and cleaning of teeth are presented in frequencies.
Numerical variables like age and plaque score were
recorded as mean and SD. Independent T test was used
to check significance of plaque score in male and female.
One way ANOVA test was applied among plaque score
and duration of fixed appliance to assess the plaque score.
Correlation analysis was done between the age of patients
and plaque index score. The level of significance was set
to < 0.05 at 95% Confidence Interval.
RESULTS
Mean plaque score was 4.29+1.58 and mean age
19.1+2.47 years. Mean values of plaque for male
2.42+0.70 and female 2.51+1.99 were statistically not
significant. (Table-1).
Male and female patients were 42% and 58% respectively.
Majority of Male and female patients were cleaning their
teeth once a day and very less number of patients were
cleaning their teeth thrice a day. (Table-2)
The analysis of variance (ANOVA) test showed
insignificant differences in plaque score and duration of
fixed appliance. (Table-3)
There was insignificant (r=0.035, p = 0.581) correlation
between age and plaque score. (Table-4)
101
Table-I Plaque Score in Male and Female
Table-2 Cross Tabulation Between Gender and Cleaning
Frequencies of Teeth
JPDA Vol. 24 No. 02 Apr-June 2015
Memon AB / Jabbar A / Shaikh IA /
Dahri WA / Malhi P / Rind SH
Plaque Score During Orthodontic Treatment in Relation
used25-26.
There was insignificant (r=0.035, p = 0.581) correlation
between age and plaque score. This finding was in contrast
with the study results of Al-Hadad KA et27 al and a study
conducted on subjects in Sana'a 28 . However some
researchers have reported similar results as ours 29,30. These
variations may be attributed to differences in methodology
or age of study samples and may also reflect genuine
differences in oral hygiene practices, culture, and food
habits. This study was conducted on orthodontic fixed
appliances patients so the results of our research may not
be valid for patients using clear aligners and removable
appliances. The data was collected by single researcher
so operator bias could not be eliminated.
Table-3 Plaque Score And Duration of Fixed Appliance
Table-4 Correlation Between Age and Plaque Score
CONCLUSION
It is concluded that:
. Plaque score was not influenced by age or gender of
our study subjects
. Plaque score did not increase with increased duration
of orthodontic treatment.
DISCUSSION
For the correction of skeletal, dental and facial
problems an effective cooperation is required between
orthodontist, hygienist, patient and specialist of related
fields linked to that problem16. If patient is motivated and
keen to control plaque effectively he may keep his dentition
for life time17. Orthodontic treatment becomes complicated
and develop undesirable effects if oral hygiene is not
maintained18.
Most of the periodontal diseases and dental caries are
caused by plaque. Therefore, plaque control must be
insisted in avoiding periodontal problems during
orthodontic treatment4.
There was insignificant difference of plaque score between
different genders. The findings of this study are in
agreement with the study of Sukhia HR19 and Attasi F,
Awartani F20. In comparison of brushing frequency, females
brushed more than male counterparts which can be
compared with the research of Sukhia HR19 and Da'ameh
M D21. This might be due to the fact that females are more
conscious about their hygiene as compared to males. Very
few patients were irregular in cleaning their teeth on daily
basis.
The current study found that plaque score does not
increase with increase in treatment duration, this finding
is not in harmony with other studies9-22,24. Optimal oral
hygiene can be achieved when proper measures are
JPDA Vol. 24 No. 02 Apr-June 2015
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