Assessment of Enamel Demineralization in Fixed Orthodontic Patients and the Effectiveness of Fluoride Varnish in Its Control

Abstract

Introduction: White spot lesions (WSLs), a typical side effect of fixed orthodontic therapy, are enamel demineralization. If left untreated, these lesions may lead to caries in addition to compromising tooth aesthetics. This research aimed to determine the frequency of enamel demineralization in orthodontic patients and the efficacy of fluoride varnish in preventing and managing it.

Methodology: This prospective interventional study was conducted at Khyber College of Dentistry (KCD), Peshawar, over a 12-month period from August 2022 to August 2023. A total of 115 patients undergoing fixed orthodontic treatment were enrolled and randomly divided into two groups: Group A (n=58) received fluoride varnish applications at three-week intervals, while Group B (n=57) served as the control group with no fluoride application. Enamel demineralization was assessed visually using the ICDAS scoring system at baseline and after three months. Data were analyzed using SPSS version 26. Chi-square and paired t-tests were applied, with p-values <0.05 considered statistically significant.

Results: At baseline, both groups had similar mean WSL counts (Group A: 3.45 ± 1.28, Group B: 3.51 ± 1.31). After three months, Group A showed a significant reduction in lesion count to 1.86 ± 0.94 (p<0.001), while Group B experienced an increase to 3.87 ± 1.45. Additionally, 50% of varnish-treated patients had no visible lesions post-treatment, compared to only 14% in the control group. The incidence of new WSLs was significantly lower in the varnish group (17.2%) than in controls (57.9%).

Conclusion: Fluoride varnish effectively reduced both the incidence and severity of enamel demineralization in orthodontic patients and should be incorporated into standard preventive care.