Distribution of White Spots after Debanding in Orthodontic Patients

Statement of problem: Fixed orthodontic appliances can interfere with removing bacterial plaques from dental surfaces which can ultimately lead to white spot formation. The aim of this study was to evaluate the quantity of white spots and areas of decalcification following fixed orthodontic treatment. A total of 100 patients undergoing or scheduled for fixed orthodontic treatment were divided into two groups. Group A consisted of fifty volunteers before the initiation of therapy and group B included fifty patients at the end of their treatment. In group A, the buccal surfaces of the first molars in each quadrant were examined for the presence of enamel decalcifications. After removing the orthodontic bands in group B, the buccal surfaces of the first molars in each quadrant were examined for white spots. Gender, oral hygiene level, plaque index, type of cement and duration of treatment were recorded for all patients. Binomial logistic regression, chi-square and Mann-Whitney U-tests were used for statistical analysis. The number of white spots in group A was 28 (14%) which was significantly lower than group B with 83 (41.5%) decalcified lesions (P<0.01). Oral hygiene and duration of treatment had a significant effect on the occurrence of white spots (P<0.05). The results showed that patients with orthodontic bands are at higher risk for white spot formation and good oral hygiene demonstrates a protective effect on their reduction. Both professional and daily oral hygiene measures can decrease the cariogenicity of bacterial plaques in these patients.