Periodontal considerations in orthodontic treatment: A review of the literature and recommended protocols

Orthodontic treatment can preserve, harm or benefit the periodontal condition.

During orthodontic treatment, patients may be at a greater risk of developing periodontal disease or conditions. Thus, the treating clinicians should carefully evaluate their patients’ periodontal conditions prior to, during, and after the completion of orthodontic treatment. This literature review describes the damage situations and the methods of preventing and repairing them as well as situations in which the orthodontic intervention contributes to the periodontal status. Recommended protocols for periodontal screening, maintenance and follow-up are presented as well.

Clinicians should conduct a complete periodontal evaluation prior to initiating orthodontic treatment, help patients develop an effective home care therapy regimen, ensure the absence of periodontal disease and or mucogingival deformities and conditions that may worsen during orthodontic treatment, and determine the appropriate recall maintenance program for the patient. During the active orthodontic phase, patients’ periodontal conditions should be carefully monitored, compared to their baseline clinical and radiographic measurements, and treated if necessary. Patients’ compliance with the suggested home oral care should be carefully evaluated and reinforced. If necessary, the orthodontic treatment may need to be stopped temporarily until patients’ home oral care improves.