Oral Hygiene is Associated with Orthodontic Pain in Patients with Treated and Stabilised Periodontitis.

PURPOSE: This prospective cohort study aimed to 1) determine whether oral hygiene (OH) is a factor affecting orthodontic pain and 2) reveal whether orthodontic pain affects OH practice during orthodontic treatment. MATERIALS AND METHODS: 35 adults aged 22-59 years with treated and stabilised periodontitis were recruited. The pre-bonding (baseline) and 1-month post-bonding OH as well as periodontal status were recorded. The experience, duration and maximum intensity of orthodontic pain within the first week after bonding were documented. In addition, the concentrations of cytokines in the gingival crevicular fluid (GCF) were recorded at baseline, 1 day and 1 week after bonding. RESULTS: Patients who experienced orthodontic pain in the first week of orthodontic treatment had a higher baseline gingival index (GI) than patients who never experienced orthodontic pain (p < 0.05), and patients who experienced a longer duration and higher intensity of orthodontic pain in the first week of orthodontic treatment also had a higher baseline GI (p < 0.05). Patients who experienced orthodontic pain in the first week of orthodontic treatment had statistically significantly higher concentrations of interleukin 1β (IL-1β) in GCF at 1 day post bonding than those who never experienced pain, while baseline GI was positively associated with cytokine concentrations in GCF at 1 week post bonding (p < 0.05). In addition, neither the experience of orthodontic pain nor its duration and intensity were associated with the level of post-bonding OH (p > 0.05). CONCLUSIONS: The finding that increased gingival inflammation accounted for the longer duration and higher intensity of orthodontic pain in treated and stabilised periodontal patient shows that oral hygiene instructions and supportive periodontal care are of great importance prior to and during adjunctive orthodontic treatment in periodontally compromised individuals.