The assessment of oral hygiene status revealed more than sixty percent (62.8%) of the subjects had good oral hygiene, over a third had fair oral hygiene and none of the patients presented with poor oral hygiene. This study revealed no statistically significant gender differences in the distribution of oral hygiene status among these orthodontic patients even though the mean oral hygiene, debris and calculus indices were slightly higher among the males than females. The subjects aged between 11-20 years old exhibited a significantly highest level of good and fair oral hygiene status. The satisfactory oral health status observed in this study therefore suggested a good ability of these orthodontic patients to control and reduce plaque accumulation around their fixed appliances. This study also revealed that the significant majority of the subjects brushed their teeth twice daily which were also consistent with high frequency of subjects with good oral hygiene. The good oral hygiene status observed among these subjects could possibly be attributed to their dental awareness and positive attitude towards oral health since most individuals who seek orthodontic treatment desire improved dental aesthetics, oral function, optimal oral health and psychological well-being [1].Routine provision of information on oral hygiene and home care instructions to the intending orthodontic patients pre-treatment at the consultant orthodontists’ clinic may also be contributory. This present study is however in contrast to the findings of Atassi and Awartani [10] who reported unsatisfactory oral hygiene in their orthodontic patients despite the fact that more than half of their patients (54%) brushed their teeth twice daily and one-fifth thrice daily. They further stated that frequency of tooth brushing alone cannot be used as a measure of the quality of oral hygiene but levels of patient’s education and motivation, and continuous reinforcement of oral home care are important factors in oral hygiene care. Hobson and Clark [11] also observed that even though many orthodontists advocate appropriate oral hygiene measures, the efficacy is largely determined by the patient’s motivation.
In a similar study among orthodontic patients in South western Nigeria using the same index by Greene and Vermillion [9], Onyeaso et al. [12] also reported a good oral hygiene in 59.6% of their orthodontic patients and 38.2% with fair oral hygiene which they attributed to their subjects attitudinal factors because of their relatively better dental awareness.
A high dental awareness and positive attitude towards oral health among patients therefore constitute significant contributory factors in achieving good oral hygiene status. It is also imperative to note that while the orthodontic patients have the responsibility to observe and maintain good oral hygiene, the orthodontists also have an important role to promote oral hygiene during orthodontic treatment which will include choice of more hygienic orthodontic appliances, provision of oral health education and advice about methods of plaque control, dietary advice, fluoride therapy, motivation and monitoring to ensure effectiveness of the oral hygiene regime with the aim of reducing plaque accumulation during treatment and prevention of corresponding adverse effects.