Comparison of two different cleansing solutions in surface bacterial plaque removal from removable orthodontic appliances

The presence of microbial plaque not only can cause unpleasant appearance but it can also cause oral tissue inflammation, malodor as well as digestive system and respiratory tract infection. The aim of this study was to evaluate the efficacy of lemon juice 10% and effervescent cleanser tablet, in removing microbial plaque from the surface of removable orthodontic appliances. This study was conducted by using interventional design. Total of 30 patients were randomly selected regardless of their gender status. They were between 9-14 years old (mean age 12) and had maxillary removable orthodontic appliances. Initially, all the removable appliances were cleaned thoroughly using ultrasonic device. Patients were instructed to come back in four days. During this period, patients were not allowed to use any kind of mouthwash or other oral hygiene products to clean their appliances. On the first recall appointment, the removable appliances were first placed in Erythrosine solution for 7 minutes and they were scored for the amount of microbial plaque present. These appliances were rescored after immersing into10% lemon juice solution for 30 minutes. The ultrasonic device was used to clean appliances before returning them to patients. A 4 day recall visit was scheduled for patients. The same plaque scoring procedure was conducted in the second appointment. This time, the appliances were immersed in a solution containing effervescent tablet for 30 minutes.This process was repeated two times in order to increase data validity. After completion of data collection, analysis was conducted using Sign Rank test. The plaque scores were decreased in 33 percent of cases (n=10) after using the first method (10% Lemon Juice); but there was no change observed in 66 percent of cases (n=20) (P=0.002). When using the second method (effervescent tablet), although plaque scores slightly decreased in all cases, the complete removal of plaque were observed in 36.6 percent of the patients (n=11) only (P<0.001). The score comparison between the two methods revealed that 93.4 percent of the cases (n=28) showed less plaque when using the second method (effervescent tablet) (P<0.001). The 10% Lemon Juice solution has little effect on reducing the microbial plaque. However, the solution made out of effervescent cleanser tablet is more effective than 10% Lemon Juice solution in removing microbial plaque from removable orthodontic appliances.