**3.1 Clinical markers**

156 Contemporary Approach to Dental Caries

When placed fixed appliances, besides the brackets, the orthodontic technique use other

The length of orthodontic treatment with fixed appliances has approximately 13-15 months; nevertheless, factors so far linked to increased treatment duration include anatomy, malocclusion, direction growth, molar class, extractions, use of fixed appliances in both

Patients who undergo orthodontic therapy have oral ecologic changes because increased

Lesions developed during orthodontic treatment could be radicular resorption, gingival recession and increase of caries risk and periodontal diseases. The enamel decalcification is one of the most common and undesirable complications of the orthodontic therapy. Some authors (Chang et al., 1999; Heintze, 1999; Zárate et al., 2004) show increase of

Demineralization of the enamel around brackets can be an extremely rapid process, which appears most frequently on the cervical and middle thirds of the buccal surfaces of the maxillary lateral incisors, mandible canines and the first premolars. The prevalence of new enamel lesions in orthodontic patients treated with fixed appliances and using fluoride

We can find periodontal alterations after orthodontic treatment such as: generalized gingivitis after bonding and light lost of alveolar bone level and of epithelial insertion

It seems, that the bone lost could be more serious when more complex and extensive will be

That is the reason because the maintenance of an effective oral hygiene is critical during the

When we do a good orthodontic treatment and with a correct regime of oral hygiene, we do

It has been demonstrated that children who receive orthodontic therapy, at the end of this treatment, presents lower dental plaque levels and gingival bleeding that children who did not receive treatment; it could be because they have better dental alignment, but also to that

Diagnostic tests may serve multiple clinical objectives that benefit the individual patient. The clinician may use tests to: a) identify predisposing risk factors to modify risk and

the subjects modify his oral personal hygiene and attitude (Gwinnett & Ceen, 1979).

We can considerate the next preventive measures in orthodontic patients:

To evaluate the periodontal conditions during the treatment.

To establish a continuos motivation for the oral care.

**3. Caries risk markers on the orthodontic treatment** 

retentive sites for retention of food particles, which allows the bacterial growth.

The patient must be motivated and cooperator.

arches, and others (Turbill et al., 2001).

(Bollen et al., 2008).

treatment.

the orthodontic movement.

To avoid the cariogenic diet.

To evaluate the toothbrushing technique.

not have important periodontal complications.

attachments as: bands (actually preformed), wires, springs or buttons.

decalcifications or white spot lesions in patient on treatment.

toothpaste is reported to be 13 to 75 % (Derks et al., 2007).

To be able to evaluate the caries risk exist different markers, principally DMFT or DMFS index and bacterial counts (Streptococci mutans and Lactobacillus). The historical experience to caries that the patient presents by the DMFT or DMFS index is one of the most powerful predictor to caries risk. Nevertheless, it is well know that the caries is multifactorial and can change from a population to other one, from an individual to other one even from a group of teeth to other one.
