Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

Evaluation of Gingival Issues Encountered by Adults

Receiving Fixed Orthodontic Treatment in Dakshina
Kannada Population: A Questionnaire Study
Dr. Sharath Kumar Shetty1; Dr. Mahesh Kumar Y.2; Dr. Ramkumar G3
1
Professor and HOD Department of Orthodontics and Dentofacial Orthopaedics KVGDCH
2
Professor KVGDCH; 3Postgraduate student KVGDCH

Abstract:- I. INTRODUCTION

 Background: The effectiveness and ease of fixed orthodontic

Fixed orthodontic components used in orthodontic appliances makes it one of the most widely used techniques
treatment can serve as a focal point for plaque and biofilm in orthodontic treatment.1
accumulation, leading to plaque-associated gingivitis.
This occurs due to the intricate interaction between the The implantation of an orthodontic device in a patient's
host (patient) and the microbial environment surrounding mouth is frequently linked to changes in the patient's oral
these components. Alterations in gingival color, shape, hygiene practices and periodontal health, even if orthodontic
size, texture, and contour should serve as warning signs therapy improves dental and skeletal disorders. Both
for both the patient and the orthodontist, prompting them mechanical treatments and orthodontic equipment have the
to take preventive measures against further progression. potential to cause localized soft tissue reactions in the
It's crucial to educate both the orthodontist and the gingiva. Effective orthodontic treatment is made more
patient about the potential complications linked to the difficult by the orthodontic appliances close closeness to the
gingival response during treatment. gingival sulcus, plaque buildup, and obstacles to good oral
hygiene practices.2-4
 Methods:
This Questionnaire study sample size of 150 was Patients receiving fixed appliance therapy for
performed to evaluate the gingival problems faced by the orthodontics may develop a range of gingival-periodontal
patients undergoing fixed orthodontic therapy in problems as a result of poor nutrition, poor oral hygiene
Dakshina kannada population . practices, and increased dental plaque buildup around
orthodontic bands and brackets.5-7
 Results:
Most individuals undergoing orthodontic treatment They make it difficult to practice proper oral hygiene,
were typically in the age range of 19 to 24 years old. There these fixed orthodontic equipment have a passive effect on
was a higher proportion of female participants compared the health of the periodontal tissue by causing plaque to build
to males, and the majority of them maintained good oral up.8the buildup of plaque surrounding the tooth-attached
hygiene. Young adults demonstrated greater awareness retentive components and the crucial periodontopathic
and understanding of the treatment, which contributed to bacteria colonization.9
improved gingival health outcomes.
Periodontal disease development and start rely on a
 Conclusion: dynamic balance between the host's immunological-
The responsibility for maintaining oral health inflammatory responses and the microbial assault. 10
predominantly rests with the patient, who must ensure
adherence to proper, effective, and thorough oral hygiene An important rise in oedema and inflammatory cells is
routines. It's imperative for every orthodontic patient to the cause of chronic soft tissue inflammation may modify the
receive encouragement and education regarding the microflora's composition and affect the subgingival ecology
gingival changes associated with orthodontic treatment by establishing the right anaerobic environment. 11
and the importance of maintaining good oral hygiene
practices. Hence this Questionnaire study was undertaken to
evaluate and to assess the gingival problems during fixed
Keywords:- Common Gingival Problems, Orthodontic orthodontic treatment experienced by adult patients in
Treatment, Patient Satisfaction. Dakshina Kannada population.

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Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

 Aim:  Statistical Analysis:

To evaluate and assess the common gingival problems Descriptive analysis will be performed with the help of
faced by patients undergoing fixed orthodontic treatment. SPSS Software and mean and standard deviation will be
recorded.
 Objectives:
 Sample Size Calculation:
 To assess gingival issues faced by adult patients during Recommended Sample size is: 150
fixed orthodontic treatment.
 To examine and appraise the patient's oral hygiene The sample size (n) is calculated according to the
regimen while receiving orthodontic treatment. formula: n= [z2*p*(1-p)/e2]/ [1+(z2*p*(1-p)/(e2*N))]
Where: z= 1.96 for a confidence level (a) of 95%, p=
II. MATERIALS AND METHODS Proportion (expressed as a decimal), N= Population size, e=
margin of error. z= 1.96, p=0.5, N=51, e=0.05 n=
 Duration of Study: [1.962*0.5*(1-0.5)/0.052]/ [1+(1.962*0.5*(1-
1 Month. 0.5)/(0.052*52))] n= 415.16/2.8325=148.523 n= 150

 Study Design: The Sample Size(with finite population correction)is

A cross sectional questionnaire based study. equal to 150 Result from open Epi, version, 3 open Source
Calculator—SS Propor.
 Place of Study:
Online questionnaire forms were sent via emails, III. METHODOLOGY
whatsapp groups of the selected participants to collect the
relevant data after taking relevant permissions and consent A Google form was developed to evaluate and assess the
from patients. common gingival issues that patients receiving fixed
orthodontic treatment encounter. The questionnaire was sent
 Inclusion Criteria: to the appropriate ethical clearance committees, together with
a brief summary outlining the goals and objectives of the
 Patients currently undergoing orthodontic treatment. research. The questionnaire was distributed to the participants
 Non surgically treated cases. following approval from the Institutional Ethics Committee
 Age group of 19 to 42 years. and the Scientific Advisory Committee.
 Only Fixed Orthodontic treatment cases.
Through emails, personal relationships and Whatsapp
 Good general health with no history of systemic disease.
groups, the investigator made contact with the participants.
 No alveolar bone loss visible on x-rays.
Pertinent reminders were delivered to each patient every
 No periodontal treatment within the last 6 months. week. Additionally, prompt reminders were given. Every
 No antibiotic therapy in the last 6 months. participant had the choice to withdraw from the study at any
 No medication known to cause gingival enlargement. time, and participation was entirely voluntary.
 Exclusion Criteria: The respondents to the questionnaire mainly comprised
of patients undergoing orthodontic treatment at the time of the
 Patients suffering from congenital abnormality, systemic survey.
illness, cysts, or crevices.
 Patient using any systemic medication that might  Questionnaire:
interfere with the gingival problems. There were many multiple-choice questions in the
 Patients who require chemoprophylaxis. set.Following inquiries concerning age, gender, the following
 Surgically treated cases. queries were posed.
 Patients treated with myofunctional appliances.
 Patients below age 19 or above age 42 years old.
 Removable Orthodontic appliance treatment cases.

Table 1: Questions Sent to Patients Participating in Questionnaire Study

Sl. no Questions
1 How many times a day do you brush?
2 Do you experience spontaneous bleeding from your gums after brushing?
3 Do you experience swelling in your gums?
4 Do you experience itching of gums?
5 Do you experience food lodgement in your gums?
6 Do you experience pain in your gums?
7 Do you experience irritation in your gums?
8 Do you experience bad breath from your mouth?

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Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

9 Do you experience pain during chewing or eating?

10 Do you experience sensitivity in teeth?
11 Do you experience receding gums or longer appearing teeth?
12 On a scale of 1 to 5 how satisfied are you with your ongoing orthodontic treatment ?

IV. RESULTS Most of participants in this study had sometimes

experience sensitivity in teeth (39.7%)followed by 32.7%
Majority of the participants belonged to the age group participants did not experience any sensitivity during
of 19 to 24, (94.2%)which represents the most common age orthodontic treatment and the rest 27.6% participants had
of undergoing orthodontic treatment (Figure 1),followed by actually experienced sensitivity. (Figure 12)
25-30 age group(5.8%)
Most of participants in this study did not experience
Most of participants were females (74.4%), with only a receding gums or longer appearing teeth (84.6%)followed by
few male patients (25.6%) (Figure 2). 8.3% participants sometimes have experienced
receding gums or longer appearing teeth and the rest 7.1% of
Most of participants brushes their teeth twice daily participants actually had experiences of receding gums or
(66.7%) and the rest of the patients brushed once daily longer appearing teeth(Figure 13)
(32.1%).(Figure 3)
When asked about their satisfaction with ongoing
Most of participants do not experience spontaneous Orthodontic treatment, on a scale from 1 to 5, most of the
bleeding from gums after brushing(77.6%)and the next major participants gave a rating of 4(30.8%),followed by 28.2%
group of patients experienced spontaneous bleeding gave a score of 3 ,then 24.4% gave a score of 5 ,14.1% gave
sometimes (16.7%).(Figure 4) a score of 1 and the rest 2.6% gave a score of 2. (Figure 14).

Most of participants rarely experienced swelling in their

gums(82.1%) and the next major group of patients
experienced swelling in gums sometimes(17.9%).(Figure 5)

Most of participants did not experience itching of

gums(94.9%)and a very few experienced it sometimes.
(Figure 6)

Most of participants did not experience food lodgement

in their gums(56.4%),followed by 24.4% participants had
experienced food Lodgement in their gums and the rest of the
participants experienced it sometimes (19.2%).(Figure 7)

Most of participants did not experience pain in their

gums(78.8%)and 14.1% maybe had pain in their gums and
the rest 7.1% actually experienced pain in their gums. (Figure Fig 1: Age of the Participants
8)

Most of participants did not experience irritation in their

gums(80.8%),12.1% participants maybe had irritation in their
gums and the rest 7.1% had irritation in their gums. (Figure
9)

Most of participants did not experience bad breath from

their mouth(64.7%)followed by 23.7% had sometimes
experienced it and the rest 11.5% had always experienced bad
breath from their mouth. (Figure 10)

In this study 73.1% participants did not experience any

pain during chewing or eating,while a group of participants
sometimes experienced it (19.9%)and 7.1% had actually
experienced pain during chewing or eating. (Figure 11) Fig 2: Sex of the Participants

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Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

Fig 3: How Many Times a Day do You Brush? Fig 6: Do you Experience Itching of Gums?

Fig 4: Do you Experience Spontaneous Bleeding from your Fig 7: Do you Experience Food Lodgement in your Gums?
Gums after Brushing?

Fig 5: Do you Experience Swelling in your Gums? Fig 8: Do you Experience Pain in your Gums?

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Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

Fig 9: Do you Experience Irritation in your Gums? Fig 12: Do you Experience Sensitivity in Teeth?

Fig 10: Do you Experience Bad Breath from your Mouth? Fig 13: Do you Experience Receding Gums or Longer
Appearing Teeth?

Fig 11: Do you Experience Pain during Chewing or Eating? Fig 14: On a Scale of 1 to 5 how Satisfied are you with your
Ongoing Orthodontic Treatment ?

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Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

V. DISCUSSION Pain during orthodontic treatment in the gums Were less

experienced by our orthodontic patients in this study.Most of
An imbalance of the oral microbiota in the dento- the patient did not experience irritation in their gums, while
gingival region and the host response, which causes gingival some had experienced sometimes. Most of the patient in the
tissue inflammation in susceptible people, are the two main study group Had a better oral hygiene Due to their brushing
causes of gingivitis. The purpose of this study was to identify habits. Which further had less response to bad breath. Pain
and analyze the most prevalent gingival issues that might during chewing or mastication Was however Not more
develop while receiving fixed mechanotherapy for common during orthodontic treatment 72.8% and participant
orthodontic treatment. This questionnaire-based study sought did experience pain during chewing or eating. 39.2%
to measure the gingival-related issues that patients may have participants experienced Sensitivity in their teeth during
during fixed orthodontic treatments.12 orthodontic treatment. And majority of the participants in our
study did not experience receding gums or long appearing
This questionnaire based study aimed at gauging the teeth. On a Scale of one to five participants had a satisfactory
gingival related problems that the patient might face during response Towards orthodontic treatment With a rating of four
fixed orthodontic therapy and also enabled to assert and being more prevalant. All these values and findings where
assess the oral hygiene protocols advocated by the patients Based on the collected response data From 156 participants.
undergoing braces treatment. It also made it possible to state
and evaluate the oral hygiene practices that patients wearing Based on the responses from this study it is clear to some
braces recommended. Both mechanical treatments and extent that orthodontic treatment do not poses serious
orthodontic equipment have the potential to cause localized problems to the gingiva ,adults patients undergoing
soft-tissue reactions in the gingiva. These effects can be orthodontic treatment had better awareness towards
beneficial, such as promoting tooth mobility, or harmful, such maintaining oral hygiene .the gingival problems which were
as gingival issues, which need to be avoided. 13 Patients previously mentioned as deleterious effects in orthodontic
receiving orthodontic treatment answered a series of treatment where easily manageable with good oral hygiene
questionnaires. and patient compliance towards orthodontic treatment
.overall most of the patients undergoing orthodontic treatment
At First, an estimate of the sample size was made using showed satisfactory response towards the treatment.
data from earlier research on the subject. Software for
calculating sample sizes was used to determine the sample VI. CONCLUSION
size. 150 people were thought to be in the sample. Then, using
Google Forms, a questionnaire was created and distributed to  The patient bears primary responsibility for maintaining
age groups ranging from 19 to 42 through emails, Whatsapp oral health by adhering to appropriate, effective, and
groups, and personal connections. The Google forms thorough oral hygiene procedures.
themselves were used to record the participants permission.  Every orthodontic patient has to be encouraged and
Following 156 participants completion of the Google informed about the changes that orthodontic treatment and
questionnaire, the information was examined as a whole. excellent oral hygiene habits bring about in the gingiva.
 young adults undergoing orthodontic treatment should be
Most of the participants in This study Belongs to 19 to the focus of motivating activities and oral hygiene
24 years which corresponds to young adults. While majority recommendations.
of participants were Female which states that motivation to
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ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN135

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