Effect of Fixed Orthodontic Appliances on Oral Microbial Changes and Dental Caries Risk in Children: A 6-Month Prospective Study

Introduction: Orthodontic treatment can alter the oral environment, leading to plaque accumulation and changes in microbial colonization. This study aimed to assess microbiological changes in 10 to 16-year-old children undergoing fixed orthodontic treatment. Methodology: The study included children aged 10–16 years, with one group wearing fixed orthodontic appliances and a control group without brackets. Data on salivary pH, buffer capacity, Streptococcus mutans, and Lactobacillus spp were collected at baseline and after 6 months. Logistic regression models evaluated associations between orthodontic treatment and elevated bacterial levels, adjusting for age, gender, pH, and buffer capacity. Results: Wearing fixed orthodontic appliances was significantly associated with elevated Streptococcus mutans (aOR: 6.62, 95% CI: 1.91–21.88) and Lactobacillus spp (aOR: 9.49, 95% CI: 2.57–35.07). Gender showed a significant association with Lactobacillus spp levels (aOR: 0.28, 95% CI: 0.09–0.87). Conclusion: Fixed orthodontic appliances significantly impact oral microbial changes, underscoring the need for proper oral hygiene during orthodontic treatment to reduce dental caries risk.