Orthodontic Appliances and Microbial Dysbiosis: Insights and Implications

Orthodontic treatment can lead to significant changes in the oral microbiome, potentially resulting in dysbiosis associated with increased risk of gingivitis and caries. The complex hard-soft tissue structures in the mouth harbour a diverse bacterial community, with around 700 different species identified. Orthodontic appliances, such as fixed braces, can alter the oral environment, leading to changes in the composition and abundance of oral microorganisms. Studies have shown that fixed orthodontic appliances, including brackets and bands, can influence the colonization of periodontal pathogens like Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum, which are associated with periodontal diseases. These appliances can also increase the levels of cariogenic bacteria such as Streptococcus mutans and Lactobacilli, which are linked to dental caries. On the other hand, clear aligners have been found to have a lesser impact on the oral microbiome compared to traditional braces, with some studies suggesting that they may even reduce the negative effects on periodontal health. However, clear aligners can still lead to changes in the oral microbiome, including increases in bacteria associated with gingivitis and periodontitis. Overall, orthodontic appliances can significantly alter the oral microbiome, potentially leading to dysbiosis and increased risk of oral diseases. Proper oral hygiene instructions and monitoring are essential to minimize these risks during orthodontic treatment.