Consequences of orthodontic treatment on periodontal health: Clinical and microbial effects

Orthodontic therapy is accomplished by inducing bone turnover in order to move teeth within the alveolus. In addition, orthodontic appliances hinder oral hygiene effectiveness and increase plaque accumulation. Therefore, it is important to examine how these changes influence periodontal health. Our current understanding is that orthodontic therapy influences the periodontium by transiently changing the microbial environment and altering periodontal clinical parameters such as attachment loss and probing depth. However, there are minimal long-term consequences except in a small subset of at-risk patients. High plaque index, subgingival encroachment of the cervical margins of bands, deep probing depths, and length of orthodontic treatment are several risk factors that can significantly increase the risk of long-term attachment loss in patients undergoing orthodontic therapy. Adults may experience fewer negative periodontal effects than children and adolescents, provided they are periodontally stable when orthodontic therapy is initiated. Careful consideration of daily oral hygiene, regular maintenance, and monitoring of periodontal status to maintain stability are critical in successful orthodontic treatment in adult populations. This review examined specific aspects of orthodontic treatment and periodontal health, including differences in responses between adults and children, factors that can influence these parameters, identifying at-risk patients, and post-treatment responses.