Effect of fluorescein-containing toothpaste on dental plaque in patients with fixed orthodontic appliances: a randomized clinical trial

The increased incidence of dental caries and periodontal disease is one of the greatest concerns of orthodontic patients. The present study aimed to assess the effect of fluorescein-containing toothpaste on removal of dental plaque in patients with fixed orthodontic appliances. We conducted a single-blind randomized controlled trial in 40 patients referred to orthodontic department of Mashhad dental school. All patients were over 12 years old with fixed orthodontic appliances. At the start of the study, proper tooth brushing was instructed to the patients. One month after regular brushing according to instructions, the patients were randomly assigned into two groups. Allocation concealment was operated via sealed packed envelope. The control group received regular toothpaste and continued brushing as before, while the intervention group received fluorescein-containing toothpaste and identified the location of the remaining plaque using the LED light. One month after oral hygiene instructions, the orthodontic plaque index (OPI) and gingival bleeding index (GBI) of patients were measured (T0). Also, OPI and GBI were measured again after 1 month of using their received toothpastes (T1). There was not a significant difference between the two groups in terms of age and sex. Also, no significant difference was found in maxillary and mandibular OPI changes (T1-T0) between the two groups after 1 month. Similarly, the mean scores of GBI reduction were not significant between the two groups. The fluorescein-containing toothpaste did not significantly reduce plaque and gingival bleeding compared to the control group after 1 month. Therefore, proper oral hygiene and patient education seem to be more important than plaque disclosing agents in reducing dental plaque around orthodontic appliances. The study was registered at the Iranian Registry of Clinical Trials: IRCT20200509047355N1. (Registration date: 30.5.2020)