Orthodontics and oral hygiene compliance


  Posted by: Dental Design      16th November 2020

Dentistry is no longer the painful, terror-inducing process it once was. Industry advances have resulted in a higher quality of care, increased comfort, and more minimally invasive treatment options that enable patients to enhance the health and appearance of their smile safely and effectively. Therefore, it’s no surprise that orthodontic procedures have become increasingly sought after in recent years, particularly as there are many solutions available now that offer patients a discreet way of achieving straighter teeth.   

Patient motivation to invest in orthodontics is being further driven by social media trends and celebrity culture. Famous faces aren’t afraid to use their online platforms to promote orthodontic treatment among their fans and followers, who – as statistics show – are the increasingly health-conscious, tech-savvy millennials that outstrip other generations when it comes to spending on their smiles. In fact, adults under 35 are splashing out a staggering £750 a year on dental treatment, spending around four times more than their parents and nearly eight times that of their grandparents. 

Research also shows that more than half of under-35s have had cosmetic dental treatment in the UK, compared to less than one in ten over 35.[1] Given these figures, it makes sense that there has been a rapid increase in the number of patients seeking orthodontics, with the most popular treatments including fixed braces – often with clear aesthetic brackets – and clear aligners.[2] As dental professionals know, orthodontic treatment can have significant long-term benefits – both clinical and cosmetic – which can ultimately help improve patients’ self-image, self-confidence, and overall quality of life.

Orthodontics is like any other dental treatment in that it is a life-long investment. Success can often depend on patient compliance, particularly in terms of adequately maintaining oral hygiene. The first few weeks or months of undergoing fixed orthodontics can be exciting for many patients, leading to a boost in motivation to follow recommended oral care instructions. However, as the treatment process draws on and is sometimes delayed or extended, oral care routines can be neglected out of boredom or a lack of enthusiasm, making it all too easy for good habits to fall by the wayside.[3], [4]

Of course, orthodontic treatment times will vary depending on the individual needs of each patient, but the process can take years to complete in some cases. Therefore, it is vital that patients understand and appreciate their role during the course of treatment. Regularly attending the dental practice for assessments and professional cleanings is essential, but patients should also be educated on the importance of following an effective at-home oral care regime. This is especially important considering orthodontic patients are more susceptible to complications such as dental caries and periodontal disease.[5], [6], [7]

This comes down to the fact that fixed orthodontic appliances quite literally create a barrier to effective toothbrushing and interdental cleaning, providing the ideal environment for plaque to accumulate. Furthermore, fixed orthodontic appliances can result in reduced salivary flow in certain areas of the mouth, which further facilitates bacterial adhesion and the formation of plaque.[8] These challenges emphasise the importance of patient compliance with oral hygiene before, during and post-orthodontic treatment.

Although the complex structure of some orthodontic appliances can impede effective plaque removal, there are many innovative solutions available that can help patients optimise their oral hygiene. Electric toothbrushes, for instance, offer significant advantages in terms of improving the toothbrushing experience. Nearly 12 million people in Britain have switched to an electric toothbrush over the last five years, with around 1 in 7 people investing in these devices because they can be connected to mobile apps that track how well users brush, or offer features such as a built-in timer. The increased affordability of electric toothbrushes adds to their appeal.[9]

Dental professionals can also recommend a Waterpik® Water Flosser to encourage optimal patient compliance with interdental cleaning, particularly in the case of orthodontic appliances. These devices deliver a pressurised, pulsating stream of water to effectively remove food debris and plaque that has accumulated between teeth, in and around orthodontic appliances, as well as along the gumline. Patients can ensure the best result with a reliable system that is accredited by the Oral Health Foundation and supported by more than 75 scientific studies. The Waterpik® Water Flosser is clinically proven to be substantially more effective at reducing plaque and gingival inflammation than both string floss[10], and interdental brushes. [11]

Good oral hygiene is essential to preventing disease and ensuring the success of orthodontic procedures. It is vital to engage with patients about the importance of maintaining healthy teeth and gums, with tailored oral care instructions provided to achieve a safe and effective clean with fixed orthodontic appliances. Dental professionals can ultimately help patients stay motivated and promote greater compliance by recommending the use of cutting-edge oral healthcare solutions that take some of the hard work out of daily toothbrushing and interdental cleaning.


For more information on Waterpik® products please visit www.waterpik.co.uk. Waterpik® products are available from Amazon, Asda, Costco UK, Argos, Boots, Superdrug online and in stores across the UK and Ireland.

 Book a free Waterpik® Professional Lunch and Learn for 1 hour of CPD – available either as a face to face meeting or a webinar. Please visit www.waterpik.co.uk/professional/lunch-learn/ 


Author – Maxwell O’Neill, professional educator for Waterpik


[1] GDPUK. (2020) Millennials spending more than three times the national average on their smiles. Available at: https://www.gdpuk.com/news/latest-news/3604-millennials-spending-more-than-three-times-the-national-average-on-their-smiles. [Last accessed: 28.07.20].

[2] British Dental Journal. (2020) Increase in adults seeking orthodontic treatment. 228(12): 908. DOI: 10.1038/s41415-020-1815-0.

[3] Cozzani, M. et al. (2016) Oral hygiene compliance in orthodontic patients: a randomized controlled study on the effects of post-treatment communication. Progress in Orthodontics. 17(1): 41. DOI: 10.1186/s40510-016-0154-9.

[4] Moresca, R. (2018) Orthodontic treatment time: can it be shortened?. Dental Press Journal of Orthodontics. 23(6): 90-105. DOI: 10.1590/2177-6709.23.6.090-105.sar.

[5] Hadler-Olsen, S., Sandvik, K., El-Agroudi, M. A. and Øgaard, B. (2012) The incidence of caries and white spot lesions in orthodontically treated adolescents with a comprehensive caries prophylactic regimen–a prospective study. European Journal of Orthodontics. 34(5): 633-639. DOI: 10.1093/ejo/cjr068.

[6] Willmot, D. (2008) Orthodontic Treatment and the Compromised Periodontal Patient. European Journal of Dentistry. 2(1): 1-2.

[7] Folco, A. A. et al. (2014) Gingival response in orthodontic patients: Comparative study between self-ligating and conventional brackets. Acta Odontol Latinoam. 27(3): 120-4. DOI: 10.1590/S1852-48342014000300004.

[8] Mei, L., Chieng, J., Wong, C., Benic, G. and Farella, M. (2017) Factors affecting dental biofilm in patients wearing fixed orthodontic appliances. Progress in Orthodontics. 18(1): 4. DOI: 10.1186/s40510-016-0158-5.

[9] Oral Health Foundation. (2020) 12 million Brits move to electric toothbrushes. Available at: https://www.dentalhealth.org/news/12-million-brits-move-to-electric-toothbrushes. [Last accessed: 28.07.20].

[10] Barnes, C. M., Russell, C. M., Reinhardt, R. A., Payne, J. B. and Lyle, D. M. (2005) Comparison of irritation to floss as an adjunct to toothbrushing: effective on bleeding, gingivitis and supragingival plaque. J Clin Dent. 16(3):71-77. Available at: https://pubmed.ncbi.nlm.nih.gov/16305005/. [Last accessed: 28.07.20].

[11] Goyal, C. R., Lyle, D. M., Qaqish, J. G. and Schuller, R. (2016) Comparison of water flosser and interdental brush on reduction of gingival bleeding and plaque: a randomized controlled pilot study. J Clin Dent. 27: 23-26. Available at: https://pubmed.ncbi.nlm.nih.gov/28390208/. [Last accessed: 28.07.20].

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