Antimicrobial effect of different brushing frequencies with fluoride toothpaste on Streptococcus mutans and Lactobacillus species in children with fixed orthodontic appliances

OBJECTIVE To evaluate the antimicrobial effect of different frequencies of brushing with fluoride toothpaste on the levels of salivary mutans streptococci and lactobacilli in children undergoing fixed orthodontic treatment. METHODS The study included 22 patients scheduled for fixed orthodontic therapy distributed between 2 groups with different hygiene regimes. All the subjects received identical braces, bands, and brackets bonded with the same material. Stimulated saliva samples were obtained before placement of the appliance and at 6, 12, and 18 weeks during the therapy. Saliva samples were cultured on selective microbial agar for the detection of microorganisms. RESULTS Salivary mutans streptococci were significantly suppressed throughout the experimental period in the group that brushed 4 times a day as compared to the group that brushed twice a day. Salivary lactobacilli were not significantly affected by the frequency of brushing with 0.32% sodium fluoride (NaF) toothpaste. CONCLUSIONS The use of 0.32% NaF-containing toothpaste more than 3 times a day has effective antimicrobial activity on mutans streptococci but not lactobacilli in the saliva of children with fixed orthodontic appliances.