Table 2.

Description and outcomes as observed in the studies selected for the systematic review

Author and year of study	Sample size	Study design	Study objective/description	Study inference/outcome
Abed et al. 2011[19]	10 adolescents (mean age 13.21 years; 4 males)	Qualitative interview- based study	The purpose of this study was to evaluate how fixed orthodontic treatment affected dietary intake and behavior. By conducting semi-structured one-on-one interviews with 10 adolescent patients receiving fixed orthodontic treatment—with a mean age of 13.21 years—the study used a qualitative methodology. By applying framework principles to identify emerging themes and ideas, the interviews were transcribed and analyzed by two separate researchers.	The two primary themes arising in adolescent patients receiving fixed orthodontic treatment were pain experience and dietary change, according to framework analysis. During the first few days of treatment, all patients complained of varying degrees of pain; however, after that, it was observed to lessen. All patients acknowledged that their diets had changed as a result of pain, difficulty chewing and biting, and dietary recommendations made by their orthodontist. Patients believed that after receiving treatment, their eating habits had improved. The study made clear the need to investigate dietary modifications across a wider population base.
Ashish et al. 2017[20]	-	Literature review	By conducting this literature review, the authors hoped to shed light on the relationship between dietary habits and the orthodontic treatment the patient received, and how nutrition may play a crucial role in enhancing the likelihood that the orthodontic therapy will be successful.	The physicians remarked that it could have been advantageous to offer dietary assistance to orthodontic patients in selecting soft food diets to optimize patients’ physiologic response to orthodontic therapy. This involved gathering nutritional history, assessing the diet, enlightening the patient about diet elements crucial to dental health, inspiring the patient to improve diet, and providing follow-up to assist the patient in changing their eating habits.
Hovell et al. 2018[21]	693 children (8-14 years old)	Randomized control trial	The authors enlisted orthodontic offices in Southern California and Tijuana, Mexico, and enlisted their patients aged 8 to 16 to participate in a two-year study to conduct a randomized controlled trial to determine whether brief exercise and dietary advice given during child patient visits their orthodontic office could improve diet, physical activity, and age- and gender-adjusted BMI. The staff gave the kids “prescriptions” for bettering their eating and activity habits at each visit to the office.	Although the authors highlighted that orthodontists might give non-dental preventative counsel to complement other health practitioners’ recommendations, the intervention, which was based on the Geoffrey Rose model, had minimal success in reaching its goals. To adequately examine the effectiveness of clinician-based brief counsel on preventing child obesity and/or reversing obesity, higher integrity to trial design was required.
Ibraheem et al. 2021[22]	-	Literature review	This review was created after searching and compiling articles from 1930 to July 2021. It emphasizes different food types that should be consumed during fixed orthodontic therapy and explains the impact of different foods and beverages on the growth and development of craniofacial structures, tooth surfaces, root resorption, tooth movement, retention, and stability after orthodontic treatment, as well as the impact on the components of fixed orthodontic appliances.	The authors noted that it might be helpful to offer dietary advice to the patient to optimize their physiological reactions to orthodontic treatments. This could be done by obtaining their nutritional history, assessing their diet, teaching them about the diet elements that are crucial for oral health, inspiring them to improve their diet, and then following up to support their efforts to alter their eating habits.
Maheshwari et al. 2017[23]	-	Literature review	The authors of this study believed that specific dietary considerations and recommendations were essential for the patient’s overall health and the success of the treatment, so they provided an overview of the relationship between diet and orthodontic treatment, including orthognathic surgeries.	According to the authors, it could have been advantageous to give the orthodontic patients proper food advice to maximize their physiologic response to the orthodontic therapy. To support patients’ efforts to alter their eating habits, practitioners needed to assume responsibility for gathering nutrition history, evaluating the diet, educating the patient about diet components and their significance for oral health, motivating the patient to improve their diet, and following up.
Mehta et al. 2020[24]	-	Literature review	The authors’ objective in performing this literature review was to establish a connection between dietary practices and the orthodontic therapy the patient underwent and how nutrition may be a key factor in increasing the likelihood that the orthodontic therapy would be effective.	It was advised that dietary advice be given to orthodontic patients in choosing soft food diets, which included obtaining nutrition history, evaluating the diet, and educating the patient about diet components important for oral health. Adequate nutrition allowed proper healing response during applied orthodontic forces that optimized the patient’s physiologic response to orthodontic treatment.
Bose et al. 2021[25]	-		Through this review, the authors sought to learn more about the role that dietary management plays in an orthodontic procedure that lessens the likelihood that the orthodontic appliance will be harmed. They thought it was advantageous for both the orthodontist and the patient undergoing treatment, as well as convenient for the orthodontist.	The authors noted that the key to successful orthodontic treatment was following an orthodontist’s recommended diet. Less breakage of orthodontic attachments, which was the most frequent mistake experienced by orthodontists, resulted from teaching a patient receiving orthodontic treatment about his or her diet.
Settineri et al. 2016[26]	61 adolescents (mean age 15.6 years)	Correlational study	The study’s objective was to examine the connection between the psychological effects of orthodontic treatment on adolescents’ levels of self-esteem and any potential relationships with their eating patterns. 61 teenagers between the ages of 12 and 22 took part in the study. The Eating Attitudes Test, the Rosenberg Self-Esteem Scale, and the Psychosocial Impact of Dental Aesthetics Questionnaire were used in interviews with each adolescent.	Although the data could not directly link eating disorders to dental aesthetics, adolescents undergoing orthodontic treatment, particularly in the early stages of donning braces, had odd eating habits and experienced a greater psychological impact of dental aesthetics. Eating habits and overall self-esteem were directly related.
Shirazi et al. 2011[27]	180 individuals (15-17 years old)	Randomized control trial	180 patients between the ages of 15 and 17 participated in this study, 90 of whom were in the study group and 90 of whom were controls. The primary goal of the study was to compare the nutrient intakes of adolescents wearing fixed orthodontic appliances and a control group matched for age and gender. A 24-hour recollection recall was used to evaluate nutritional intake, and demographic information was gathered using questionnaires.	Orthodontic patients consumed about the same total calories, protein, and carbohydrates as the control group did, but they consumed more total fat, saturated fat, monounsaturated fat, polyunsaturated fat, linolenic fat, linoleic fat, and cholesterol. They also consumed significantly less fiber, chromium, and beta-carotene. Other macro- and micronutrient intake did not vary considerably between the groups.
Singh et al. 2017[28]	-	Literature review	The authors of this research discussed the connection between nutrition and orthodontic therapy because they thought that a balanced diet was essential for successful orthodontic treatment and should be taken into account by both the patient and the orthodontist.	The authors pointed out that to improve the patient’s physiological responses to orthodontic treatments, it would be beneficial to provide nutritional recommendations. This could be achieved by learning about their nutritional background, evaluating their diet, educating them about the diet components that are important for dental health, motivating them to change their diet, and then following up to support their efforts to adjust their eating patterns.

BMI: Body mass index