An orthodontic tooth brushing technique to enhance oral hygiene in patients wearing fixed orthodontic appliances: A randomized controlled trial

Background: An effective tooth brushing technique is essential in maintaining oral hygiene, especially for patients wearing fixed orthodontic appliances. Traditional tooth brushing techniques are mainly designed for the general population without orthodontic appliances, which may not account for the oral condition of orthodontic patients due to the increased biofilm formation. The aim of this study was to design an orthodontic tooth brushing technique and compare its effectiveness with the traditional modified Bass technique. Methods: Sixty patients wearing fixed orthodontic appliances were included in this two-arm paralleling randomized controlled trial. Thirty patients were assigned to the modified Bass technique group and 30 patients were assigned to the orthodontic tooth brushing technique group. The orthodontic tooth brushing technique involved a biting motion on the head of toothbrush in order to place the toothbrush bristles behind the archwires and around the brackets. Plaque index (PI) and gingival index (GI) were used to assess oral hygiene. Outcome measurements were taken at baseline and 1 month after the intervention. Results: The new orthodontic tooth brushing technique significantly reduced PI (average PI reduction = 0.42 +/- 0.13), especially in the gingival (0.53 +/- 0.15) and interproximal (0.52 +/- 0.18) areas (p < 0.05 for all). No significant reduction was found for the GI (p > 0.05 for all). Conclusion: The new orthodontic tooth brushing technique showed a promising result in reducing PI in patients wearing fixed orthodontic appliances.