Abstract
BACKGROUND: Orthodontic treatment can easily cause local soft tissue reactions in the oral cavity of patients under mechanical stress, leading to oral mucosal ulcers and affecting their quality of life. At present, only limited literature has explored the factors leading to oral ulcers in orthodontic treatment, and these research results are still controversial. AIM: To investigate the current status and related factors of oral mucosal ulcers during orthodontic treatment, aiming to provide a valuable reference for preventing this disease in clinical practice. METHODS: A total of 587 patients who underwent orthodontic treatment at the Peking University School of Stomatology and Hospital of Stomatology between 2020 and 2022 were selected and allocated to an observation or control group according to the incidence of oral mucosal ulcers during orthodontic therapy. A questionnaire survey was constructed to collect patient data, including basic information, lifestyle and eating habits, treatment details, mental factors, and trace element levels, and a comparative analysis of this data was performed between the two groups. RESULTS: A logistic regression model with oral ulcers as the dependent variable was established. The regression results showed that age (≥ 60 years: odds ratio [OR]: 6.820; 95% confidence interval [CI]: 2.226-20.893), smoking history (smoking: OR: 4.434; 95%CI: 2.527-7.782), toothbrush hardness (hard: OR: 2.804; 95%CI: 1.746-4.505), dietary temperature (hot diet: OR: 1.399; 95%CI: 1.220-1.722), treatment course (> 1 year: OR: 3.830; 95%CI: 2.203-6.659), and tooth brushing frequency (> 1 time per day: OR: 0.228; 95%CI: 0.138-0.377) were independent factors for oral mucosal ulcers (P < 0.05). Furthermore, Zn level (OR: 0.945; 95%CI: 0.927-0.964) was a protective factor against oral ulcers, while the SAS (OR: 1.284; 95%CI: 1.197-1.378) and SDS (OR: 1.322; 95%CI: 1.231-1.419) scores were risk factors. CONCLUSION: Age ≥ 60 years, smoking history, hard toothbrush, hot diet, treatment course for > 1 year, tooth brushing frequency of ≤ 1 time per day, and mental anxiety are independent risk factors for oral mucosal ulcers. Therefore, these factors should receive clinical attention and be incorporated into the development and optimization of preventive strategies for reducing oral ulcer incidence.