Assessment of plaque bacteria in patients with Juvenile Idiopathic Arthritis

Aim: Make an evaluation about the changes of bacterial plaque in patients with Juvenile Idiopathic Arthritis from the first meeting and after every single session of Oral Hygiene during the whole period of orthodontic treatment. Since the early nineties, in the Major Hospital of Policlinico in Milan – Faculty of Dentistry, Department of Orthodontics is now active the Oral Hygiene Service for patients who suffer from Juvenile Idiopathic Arthritis. During the session of oral hygiene instructions, a sample of the oral plaque is removed to be examined in the laboratory under the microscopy to get a qualitative and quantitative assessment of plaque bacteria. Methods: 250 patients with Juvenile Idiopathic Arthritis were enrolled in the study, all patients are in an orthodontic treatment phase. A sample of oral plaque is collected using a special shaped tiny handle from the lingual surface of the first right lower molar. Before the beginning oral Hygiene session, samples of oral plaque are collected at every meeting with the patients. These samples can be conserved in a test tube filled with physiologic solution (0.5 ml) and then sent to laboratory to be analyzed. In laboratory, after a good shaking of the test tube, a drop which of physiological solution contains oral plaque bacteria can be isolated. This drop must be positioned on a microscopy slide and coloured using Gram Staining method to get a quantitative assessment. The remaining part of the collected sample inside the test tube must be dilute with 9.5 ml of physiological solution. After adding a vital coloring (methylene blue) a drop must be isolated and positioned in the Hemocytometer grid to get a quantitative assessment. Just like an average the patients enrolled in this study are subjected to 3 oral plaque sample examination. Results: After 3 oral plaque sample examinations, it has been noticed that the number of Cocci and Bacilli found on the dental surface is sharply reduced quantitatively and qualitatively. Conclusion: A right and constant oral hygiene, it is a fundamental component of an orthodontic treatment mostly in patients who suffer from particular pathologies which could limit the dexterity requested to get a good oral hygiene. It is been confirmed by the statistic results obtained in this study, the importance of the Oral Hygiene Instruction sessions for patients with Juvenile Idiopathic Arthritis Before and during the orthodontic therapy. the constant check of oral hygiene on a short distance of time has the aim to reduce the percentage of pathogenic bacteria and consequently reduce the incidence of a negative repercussion on the oral health of patients during the orthodontic therapy.