Take Home Pearl: Poor oral hygiene in orthodontic patients can harbor unwanted and potentially dangerous antibiotic-resistant microbes. Background:
Orthodontic appliances create the potential to harbor unwanted bacteria when oral hygiene is poor. Objective:
To attempt to isolate Enterococcus and Escherichia coli from the mouths of orthodontic patients with poor hygiene. Design:
Clinical study with control group. Participants:
46 orthodontic patients with fixed appliances in place and 55 healthy control volunteers. Methods:
A supragingival plaque sample was obtained from each mouth. For the orthodontic patients, the plaque was sampled using a gingival scaler to the bracket base; for the control subjects, it was swabbed from the supragingival area. The plaque was grown in media specific for Enterococcus and E. coli to identify the presence of these microbes. Resistance to antimicrobial medications was tested for 11 specific antibiotics, and polymerase chain reaction was used to test for genes known to be involved in antimicrobial resistance. Results:
No Enterococcus or E. coli was present in the mouths of the healthy control subjects. Twenty percent of orthodontic patients were positive for the presence of Enterococcus or E. coli, and all of these patients had poor oral hygiene. Many of the bacteria isolated from the orthodontic subjects were found to be resistant to common antibiotic agents, and many had genes identified with resistance. Conclusions:
Poor oral hygiene in orthodontic patients can harbor unwanted and potentially dangerous antibiotic-resistant microbes. Reviewer’s Comments:
The presence of these unwanted bacteria may not be dangerous for a healthy adolescent patient but could be problematic for someone who is immune compromised or otherwise not in good health. This is another good reason to promote good hygiene in patients with orthodontic appliances. Reviewer:
Brent E. Larson, DDS, MS
Orthodontic appliances create the potential to harbor unwanted bacteria when oral hygiene is poor. Objective:
To attempt to isolate Enterococcus and Escherichia coli from the mouths of orthodontic patients with poor hygiene. Design:
Clinical study with control group. Participants:
46 orthodontic patients with fixed appliances in place and 55 healthy control volunteers. Methods:
A supragingival plaque sample was obtained from each mouth. For the orthodontic patients, the plaque was sampled using a gingival scaler to the bracket base; for the control subjects, it was swabbed from the supragingival area. The plaque was grown in media specific for Enterococcus and E. coli to identify the presence of these microbes. Resistance to antimicrobial medications was tested for 11 specific antibiotics, and polymerase chain reaction was used to test for genes known to be involved in antimicrobial resistance. Results:
No Enterococcus or E. coli was present in the mouths of the healthy control subjects. Twenty percent of orthodontic patients were positive for the presence of Enterococcus or E. coli, and all of these patients had poor oral hygiene. Many of the bacteria isolated from the orthodontic subjects were found to be resistant to common antibiotic agents, and many had genes identified with resistance. Conclusions:
Poor oral hygiene in orthodontic patients can harbor unwanted and potentially dangerous antibiotic-resistant microbes. Reviewer’s Comments:
The presence of these unwanted bacteria may not be dangerous for a healthy adolescent patient but could be problematic for someone who is immune compromised or otherwise not in good health. This is another good reason to promote good hygiene in patients with orthodontic appliances. Reviewer:
Brent E. Larson, DDS, MS
