Awareness of plaque-induced gingivitis during fixed orthodontic treatment due to oral hygiene practices among Malaysian university students

Background: Fixed orthodontic treatment (FOT) is instrumental in addressing dental and skeletal discrepancies; however, it serves as a local predisposing factor for plaque-induced gingivitis. The placement of the fixed orthodontic appliance (FOA) components exacerbates plaque accumulation in the adjacent gingival sulcus, around bracket perimeters and beneath archwires. The mechanical hindrance posed by FOA complicates routine oral hygiene practices, thereby predisposing individuals to plaque-induced gingivitis. This study aimed to evaluate the awareness of periodontal health; as well as the knowledge and attitude of oral hygiene education (OHE) among Malaysian university students undergoing FOT. Methods: The study also compared the routine oral hygiene practices and OHE knowledge across different durations of FOT and between dental and non-dental students with FOA. A questionnaire-based study was conducted among 394 Malaysian university students (mean age=23.12 years, σ=3.01), all of whom had ceramic or metal brackets in either conventional or self-ligating systems. The average duration of orthodontic treatment was 16.61 months (σ=7.73). Results: The results indicated a moderate awareness of periodontal health (mean score: 1.33, σ=0.28). Statistically significant differences were observed between the FOT duration and OHE knowledge and attitudes (P<0.001); as well as between dental students with FOA and their adherence to routine oral hygiene practices (P<0.01). Conclusion: In conclusion, Malaysian university students undergoing FOT demonstrated moderate awareness of periodontal health and OHE knowledge. These findings emphasize the necessity of reinforcing oral hygiene education, particularly for non-dental students, to mitigate the oral health challenges associated with FOA.