UCLA

Although orthodontic treatment does not directly damage the teeth, it causes a change in the oral environment leading to an increased risk of periodontal disease and white spot lesions (WSLs), which are visible areas of demineralized enamel. This study aims to investigate the efficacy of different commercially available fluoride varnishes to treat WSLs after the completion of orthodontic treatment and evaluate their effect on the salivary parameters and the oral microbiome. The study followed a split-mouth design, with each of the subjects receiving different treatment on the left and right sides of their mouth. Subjects were assigned to one of three groups, with each group receiving two of the following three treatment options: placebo varnish (petroleum jelly), 5% sodium fluoride varnish (Henry Schein Acclean), and a light-cured fluoride varnish (3M XT Extended Contact Varnish). There were a total of 4 visits for this study: T0 (within 30 days of removing braces), T1 (day 30), T2 (day 90), and T3 (day 180). At each visit, subjects completed an Oral Health Questionnaire and the severity of the WSLs was assessed using DIAGNOdent laser fluorescence pen. The scores were used to assess the efficacy of the different interventions at re-mineralizing WSLs. To test the resting flow rate of saliva and salivary consistency, lower lip labial secretion and the resting salivary consistency in the oral cavity were visually assessed, respectively. Collected saliva was kept for measuring flow rate, pH, and buffering capacity. Although the study is still ongoing and therefore had a small sample size of 17 subjects enrolled at the time of data analysis, some notable trends were observed. DIAGNOdent measurements showed an interesting trend with a decrease of 20% in scores for WSLs treated with the placebo varnish and 5% NaF groups over the observation period. In contrast, the LCFV group showed a small albeit not significant increase in DIAGNOdent scores during the first 6 months after orthodontic treatment. The differences in pH between the treatments were relatively small and not clinically significant. When examining the colony-forming units (CFUs), an interesting pattern emerged in terms of the proportions of S. mutans and C. albicans relative to the total microbial load. The non-significant 9.75% increase in total microbial load, was accompanied by an 81.66% decrease in C. albicans load, and an 81.35% decrease in S. mutans load. This resulted in an overall decreasing trend in the proportions of S. mutans and C. albicans relative to the total bacterial load. However, to obtain more reliable and conclusive results it is necessary to increase the sample size.