Strengths and limitations
throat, tooth brushing
The strength of this project was the robust randomized double-blinded placebo-controlled design and the clinical scoring was robust and reliable. The efficacy of tooth brushing has an effect on biofilm formation. However, the two groups were under orthodontic treatment for at least 3 months before the start of the trial and the baseline levels in the groups are similar. Thus, it is assumable that tooth-brushing routines were the same for the test and placebo groups. Nevertheless, there were still some uncertainties to consider. We experienced an unexpected high-attrition rate due to COVID-19-related restrictions, which unfortunately lowered the power of the study. We sampled and analysed unstimulated whole saliva as a proxy for the oral microbiome and dental biofilm. The salivary microbiota constitutes a compilation of bacteria shed from all oral surfaces, including the tongue and the throat (