Relationship between orthodontic treatment and dental caries: results from a national survey

Abstract

Objectives Orthodontic treatment has been suggested to increase the risk of dental caries. The aim of this study was to evaluate the association between orthodontic treatment and the likelihood of dental caries. Methods The study included data for adults aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey in 2013–2015. The participants’ demographic, socio‐economic, and general and oral health‐care data were collected by trained interviewers using a structured questionnaire. The number of decayed teeth (DT) and the decayed, missing and filled teeth (DMFT) index score on oral examinations performed by dentists were compared between subjects who underwent orthodontic treatment and those who did not, using the chi‐squared test and logistic regression analysis. Results All logistic regression analysis models showed a significant association between orthodontic treatment and untreated dental caries. The likelihood of having untreated dental caries was lower in subjects who had received orthodontic treatment than in those who had not, regardless of confounding factors (P < 0.001). After adjustment for confounding factors, the mean number of DT was lower in subjects who had received orthodontic treatment than in those who had not (0.66 vs. 0.94; P < 0.001). There was no statistically significant difference in the DMFT index score between the two groups. Conclusions Orthodontic treatment was associated with a decreased likelihood of untreated dental caries. Moreover, there was no evidence indicating a link between the DMFT index score and orthodontic treatment.

Orthodontic Treatment as a Protective Factor for Dental Caries Experience and Severity: A Population-Based Study

“…Most of those studies(18-21) had questionable methodological quality attributable to numerous reasons, including convenient sampling with inherent selection bias, insu cient sample sizes leading to false-negative results (i.e., type II error), incorrect statistical procedures such as parametric analyses on non-normally distributed dependent variables such as DFT components and aggregates, lack of control for confounding factors, and no accountability for dental caries severity. Two studies (20,21) were in agreement with this study's ndings showing a signi cant protective association between a previous history of orthodontic treatment and untreated caries (i.e., DT) later in life, whereas one other study (18) found no signi cant association. Only two studies (18,20) investigated the effect of a previous history of orthodontic treatment on the number of FT and found no signi cant associations, which contradicts the present nding of positive association.…”

“…Identi cation of the factors that contribute to high caries susceptibility will allow clinicians and public health personal to e ciently apply targeted prevention, which has been recognized to be a cost-effective approach (36). Despite previous efforts by scholars to examine the association between the history of previous orthodontic treatment and caries development later in life (18)(19)(20)(21), none of the reported studies accounted for the highly caries-susceptible individuals (i.e., those with DT > 2, FT > 11, and DFT > 12 in this study population). This cross-sectional study intended to ll this gap in the current literature by using population-based data to comprehensively assess the effect of orthodontic treatment on dental caries experience, prevalence, and severity later in life by using a sample representative of U.S. adults.…”

“…Pro t et al have previously reported that orthodontically treated adults in the NHANES III data had signi cantly fewer malocclusion traits than those who were not treated (37). In addition, evidence from the literature shows that those with a history of orthodontic treatment had superior oral healthcare and practice than those without a history of orthodontic treatment (21).…”

“…Published studies that assessed the association between a previous history of orthodontic treatment and caries experience later in adulthood have been sparse and inconclusive (18)(19)(20)(21). Most of those studies(18-21) had questionable methodological quality attributable to numerous reasons, including convenient sampling with inherent selection bias, insu cient sample sizes leading to false-negative results (i.e., type II error), incorrect statistical procedures such as parametric analyses on non-normally distributed dependent variables such as DFT components and aggregates, lack of control for confounding factors, and no accountability for dental caries severity.…”

“…However, current research is focused on the oral health bene ts of orthodontic treatment, beyond its esthetic bene ts (17). Data outlining the ability of orthodontic treatment to reduce the risk of dental caries development later in life remains contradictory and inconclusive (18)(19)(20)(21) with low methodological quality (17). The low quality of these studies can be mainly attributed to the absence of a detailed sampling process, the exclusion of response rate reporting, and inappropriate sample size calculation (17).…”