Estimation and correlation of salivary calcium, phosphorous, alkaline phosphatase, pH, white spot lesions, and oral hygiene status among orthodontic patients

The initial carious lesions are the so-called "white spot" lesions (WSLs), which implies that there is a subsurface area with most of the mineral loss beneath a relatively intact enamel surface. It is common in patients who are taking orthodontic treatment. Salivary reservoir of calcium and phosphorous counteracts the demineralization and encourages re-mineralization providing protection against caries challenge. This study was aimed to estimate and correlate the oral hygiene status, WSLs and salivary calcium, phosphorus, alkaline phosphatase (ALP), and pH in patients undergoing fixed orthodontic therapy.All clinical and biochemical parameters were recorded in 27 patients before starting orthodontic treatment and at 6 months of orthodontic treatment. The salivary calcium, phosphorous, ALP, and pH were determined by Arsenazo III method, Molybdate - UV and the International Federation of Clinical Chemistry method, respectively. International caries detection and assessment system index for WSL, orthodontic plaque index, bleeding on probing, and gingival index were recorded. Shapiro-Wilk's test and Wilcoxon test were applied to the data collected for statistical analysis.There was a statistically significant increase with ALP levels, orthodontic plaque index score, gingival index score, and bleeding on probing index score. A statistically significant reduction was seen with respect to levels of calcium and pH.Maxillary canines and lateral incisors were the most affected teeth with WSLs (78.84%). There is a need for more stringent prevention programs and oral hygiene practices prior to initiation of orthodontic treatment and also during orthodontic treatment.