Prophylaxis during multibracket appliance treatment : a survey among general dentists in Germany

Abstract

Background: Accomplishing good oral hygiene represents a major challenge during multibracket appliance (MBA) treatment. In Germany, children, and adolescents between 6 and 18 years of age can attend an individual prophylaxis (IP) program free of charge twice a year. As part of this, they undergo training and receive recommendations to enhance oral hygiene. However, it remains unclear whether the general dentist feels responsible for prophylaxis during MBA treatment and how they adapt the IP sessions compared to patients without fixed appliances. Aim: To assess how general dentists manage IP in children and adolescents undergoing MBA treatment. Method: A questionnaire was sent to 2744 general dental practices in the region of Hesse, Germany. Dentists were asked regarding their opinion on the responsibility for prophylaxis during MBA treatment, the oral hygiene recommendations given to those patients and how they adapt the prophylaxis sessions to special MBA needs. Results: The response rate was 37.0% (n = 1014). While only 8% of the respondents consider the orthodontist as primarily responsible for IP in MBA patients, the majority considers the general dentist (46%) or both, the general dentist and the orthodontist (46%) to be responsible for IP in MBA patients. The vast majority of respondents answered that compared to patients without fixed appliances, MBA patients receive different oral hygiene recommendations during IP sessions. These recommendations are mostly related to 1. a longer toothbrushing duration (> 3 min) and 2. the use of additional tools for mechanical plaque removal (interdental brushes). Conclusion: The majority of respondents perceive the general dentist as having primary or shared responsibility for IP during MBA treatment and adapt oral hygiene recommendations to the special requirements. However, the large proportion of perceived shared responsibility also suggests considerable room for improvement. Furthermore, analysis showed a large range regarding oral hygiene recommendations, indicating the need for standardized clinical guidelines.