Incidence of initial caries around brackets, aesthetic-zone teeth only · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
When only aesthetic-zone teeth (incisors and canines) were considered, two studies reported a significant reduction in initial caries incidence favoring fluoride mouthrinse (ungraded, narrative; no pooled estimate).
1 finding from 1 review
Incidence of proximal (interdental) caries lesions from bitewing radiographs · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
Only one included study assessed proximal caries incidence from bitewing radiographs; it was not included in the meta-analysis and no pooled estimate is available (ungraded).
1 finding from 1 review
Incidence of initial enamel caries / white spot lesions adjacent to bracket base (subject level, dichotomized) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
Adding a fluoride mouthrinse to daily fluoride toothpaste produced a small reduction in the incidence of initial caries/white spot lesions adjacent to brackets (pooled risk difference -0.07, 95% CI -0.14 to -0.01; 5 studies, 491 subjects), but the authors judged the overall evidence inconclusive (ungraded).
1 finding from 1 review
Side effects or other adverse events · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
No adverse effects were reported in any of the seven included studies (ungraded).
1 finding from 1 review
Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
Chlorhexidine mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.
1 finding from 1 review
Plaque · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
Herbal mouthwash reduced some plaque-related indices versus placebo, with low-certainty evidence.
1 finding from 1 review
Probing pocket depth (PPD/PD) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
Chlorhexidine mouthwash may reduce pocket probing depth versus placebo in the short term (low certainty).
1 finding from 1 review
Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
Herbal mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.
1 finding from 1 review
Prevalence of white spot lesions (WSL) at debonding, subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances
Fluoride varnish applied regularly during fixed orthodontic treatment may reduce the prevalence of white spot lesions at debonding (pooled RR 0.64, 95% CI 0.42 to 0.98), but the certainty of evidence is very low.
1 finding from 1 review
Gingival inflammation-related index · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
Herbal mouthwash reduced gingival inflammation-related indices versus placebo, but certainty is very low.
1 finding from 1 review
Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.
1 finding from 1 review
White spot lesion clinical score (mean values), subject level · Healthy adolescents and adults undergoing orthodontic treatment with fixed multi-bracket appliances
In a pooled analysis of two placebo-controlled trials, fluoride varnish also reduced white spot lesion clinical scores (pooled SMD -0.44, 95% CI -0.64 to -0.24); this secondary outcome was not separately GRADE-rated.
1 finding from 1 review
Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)
Chlorhexidine mouthwash probably reduces the Gingival Index versus placebo in the short term (WMD -0.45, 95% CI -0.70 to -0.20; low certainty).
1 finding from 1 review