Treatment protocol to control Streptococcus mutans level in an orthodontic patient with high caries risk.

The purpose of this article is to report a protocol for treating an orthodontic patient with a high risk of developing caries. The salivary level of Streptococcus mutans was evaluated during various stages of orthodontic treatment. It was significantly high before professional application of 1% chlorhexidine collagen gel, daily mouth rinsing with 0.05% sodium fluoride solution, and bonding of the bands and brackets. Although there were no other changes in hygiene habits, microbiologic tests showed that the microbiota was in balance during the follow-up periods. At the end of orthodontic treatment, periodontal health was observed, and enamel surfaces showed signs of remineralization.