Oral health knowledge and practice among orthodontic clients in China and New Zealand.

Background: The oral hygiene habits of clients wearing fixed orthodontic appliances is poorly understood. Assessment of oral hygiene behavioural patterns is essential for understanding clients' oral health care needs. The aim of this study was to investigate orthodontic clients' oral hygiene behaviours, brushing techniques, and oral hygiene awareness.

Methods: A total of 200 orthodontic clients wearing fixed orthodontic appliances were consecutively recruited from the Sichuan Provincial Hospital, Chengdu, China, and the Faculty of Dentistry, University of Otago, Dunedin, New Zealand. A 47-item questionnaire was used to survey study participants.

Results: The survey had a 92% response rate, with 67.5% of respondents being female and 32.5% male. Most were non-smokers (94.2%) and the majority (80.0%) brushed their teeth twice daily. Most (80.4%) brushed their teeth for 1 to 2 minutes, and 68.7% positioned their toothbrush both horizontally and vertically, with horizontal being the preferred direction of motion. One-third (33.5%) did not use any auxiliary oral hygiene aids; most snacked between meals; only 31.4% received professional tooth cleaning during orthodontic treatment; and 56.8% experienced an increased level of halitosis after appliance placement. Most respondents (79.4%) thought their oral hygiene was good, but 51.0% reported bleeding gums during tooth brushing, 31.4% found they rarely bled, and only 17.6% reported no bleeding. Most respondents agreed that good oral health was very important for orthodontic treatment and that their own efforts were the most important factors.

Conclusions: Client awareness of the importance of oral hygiene during orthodontic treatment requires improvement. Clinician reinforcement of oral hygiene should become a priority for orthodontic clients.