Discussion
’, tooth
SECONDARY
Treatment with fixed orthodontic appliances interferes with mechanical tooth cleaning which results in the accumulation of dental biofilm, in particular, among patients with irregular tooth-brushing habits. Our intention with this pilot study was, therefore, to evaluate the possible effects of the enzyme-based mouthwash on a mature dental biofilm rather than on the ‘de novo’ formation. In this context, it is important to keep in mind that a biofilm with a climax bacterial community may be harder to affect with a mouthwash than a regularly disrupted dental biofilm. Therefore, our results with respect to the primary endpoint was encouraging. We found that the experimental enzyme-containing product could reduce the biofilm levels in adolescents under treatment with fixed orthodontic appliance and therefore, we rejected the null hypothesis. The mean difference between the groups was 0.7 OPI units, which was of clinical importance. The mode of action for the tested blend of enzymes (DNAse, mutanase, and glucanase) was most likely disintegrating the architecture of the biofilm through hydrolysis of extracellular DNA in the biofilm matrix, create a change in the diffusion properties, and break down large bacteria-produced polysaccharides via hydrolysis (Concerning the secondary outcome, it was important to rule out any negative impact on the quality of the oral microbiota. The analyses of the salivary microbiome displayed a typical composition for the human oral environment on Phylum, Family, and Genus levels. We found no major treatment effects on the composition which was in line with previous studies on short-term interventions with agents such as fluoride, xylitol, and probiotics (