The association between orthodontic treatment and dietary intake in adolescent patients

Abstract

Background and Aims: Fixed appliances have been reported to cause dietary restrictions, however available literature carries many caveats, and there’s lack of knowledge about whether dietary changes fall within normal ranges and whether they affect tooth movement. Therefore we aimed to assess acute and long term effect of fixed appliances and palatal expansion on dietary intake in adolescent patients; explore the healthiness of the reported dietary changes and their effect on tooth movement rate. Methods: Patients (11-21yr) were recruited from the Orthodontics Clinics of AUBMC: 95 requiring treatment with fixed appliances, and 20 to be treated with palatal expansion. BMI and dietary intake were evaluated at baseline, 1, 5 and 13 weeks after treatment initiation to detect changes in nutrients and food categories. Participants completed a pain diary during the study period, and cephalometric measurements were performed on the initial lateral cephalometric X-ray to evaluate the influence of pain and initial severity of the malocclusion on dietary changes. Those changes were correlated with the rate of tooth movement computed by measuring the Little’s irregularity index on sequential dental casts. Changes in dietary intake across time and across categorical variables were tested through analyses of variance; Pearson correlation product moment was employed for associations among different variables. Results: In the fixed appliances group, BMI did not differ along the study period although total energy and absolute food intakes significantly decreased at 5weeks of treatment and further decreased at 13weeks. Adolescents adopted unhealthy dietary habits initially reflected by inadequate fiber (g-d) potassium (mg-d) and calcium (mg-d) intakes and high fat intake (percentEI) especially saturated fat (percentEI). These habits deteriorated during treatment due to decreased intakes of fruits-dried fruits (g-d), starchy vegetables (g-d) and dairy products (g-d) and increased intakes of pizzas-pies (percentEI) and oils (percentEI). Diet