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Implementing a Preventive Care Regimen for Orthodontic Patients

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Many dentists and orthodontists find it hard to impress upon young patients how important it is to brush their teeth regularly, especially if they are wearing bracket systems. Teenagers and adolescents often don’t get that they could end up with white spot lesions (WSLs) and cavities unless they take extra care with their oral hygiene while wearing orthodontic appliances. To address this cause of frustration for oral care professionals, 3M Oral Care suggests a proactive regimen for ortho patients that provides a systemized approach to decreasing WSLs, even if the patient is a star brusher.

Of course it would be ideal if ortho patients established good oral hygiene habits before treatment commences. Adolescents and teens should be able to grasp (if not dig) the science when it is explained to them that if they don’t interrupt the oral microflora every 8 hours, bacteria will grow around their brackets and they could end up with WSLs and even moderate to severe gingivitis. Throwing in some info on how easy it is to floss around braces with today’s devices, and the impact bad breath will have on their social life can’t hurt either. But to really safeguard the outcome, try this:

After brackets are placed and stable, apply a coat of 3M Vanish XT Extended Contact Varnish on surrounding tooth structure to provide a layer of protection in high-risk, caries-prone areas. Vanish XT is a high-fluoride resin-modified glass ionomer coating that will release fluoride, calcium and phosphate for up to 6 months. To apply, the teeth should be cleaned around the brackets with an oil-free prophy paste (such as 3M Clinpro Prophy Paste), rinsed, lightly air dried, acid etched, and rinsed and lightly dried again. Next, a thin layer of 3M Vanish XT Extended Contact Varnish is painted on with a brush and light cured for 20 seconds. The varnish has a delayed auto-setting mechanism that will ensure complete curing in areas that might be hard to light cure. Repeating this every 6 months, and recommending using fluoride toothpaste, such as 3M Clinpro 5000 Sodium Fluoride Anti-Cavity Toothpaste, to recharge the Vanish XT during brushing, will keep the bacteria barrier at the bracket/tooth interface intact, preventing the release of acid in accumulated plaque that can lead to demineralization.

If patients demonstrate poor oral hygiene at recall appointments, using an air polisher unit and 3M Clinpro Glycine Prophy Powder could further improve matters. Glycine is not as abrasive as sodium bicarbonate and safe to use around orthodontic appliances. Removing plaque buildup with an air polisher and Clinpro Glycine Prophy Powder will stimulate the gingiva as well. An additional step that can be incorporated into the protocol is applying 3M Vanish Sodium Fluoride White Varnish if patients report that their teeth have become sensitive. This varnish will also recharge the Vanish XT fluoride as well as reduce hypersensitivity.

Using this 3M family of products to manage WSLs and decay in ortho patients will help those who don’t, or can’t, keep up with oral hygiene maintenance to end up with more than just an improved smile line. They’ll have healthy, good looking teeth as well. For more information, click here.

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