Internet information about orthodontic braces varies in quality and may not be entirely accurate, according to a new study from the Netherlands. 

Orthodontic patients may look for information on the Web, but some people have questioned the quality of that information, the researchers write in the Journal of the American Dental Association.

The study team used the search engines Google, Yahoo and Bing to find websites giving advice on oral hygiene for braces.

They used the search terms “cleaning braces,” “brushing braces” and “oral hygiene and braces."

Overall, they evaluated 62 websites for accessibility, usability, reliability, readability and completeness of information, such as instructions about tooth brushing, dietary advice, fluoride recommendations, and dental care accessories.

The majority of websites evaluated were authored by professionals in the field. More than 70% were edited by orthodontists. But for 15%, the author was unknown.

The websites scored, on average, at the high end of the moderate range for accessibility. Websites with video instructions were considered more accessible, because they may be more helpful to patients with impaired vision or hearing.

In terms of readability, the pages were rated to be moderate, meaning that on average, they were easily understandable for 13- to 15-year-olds.

The completeness of information varied, but was also scored as moderate. Most websites had information about brushing methods and diet information, and about half recommended fluoride toothpaste. Only 17 websites gave complete guidelines for oral hygiene, however.

The researchers say accurate information about cleaning braces is important for dental health. Patients who do not properly clean their teeth may be more likely to suffer from gingivitis and difficult-to-treat white spots on their teeth, they write.

Study author Dr. Christos Livas from the University of Groningen feels that although the scores were moderate overall, there is much room for improvement, saying in an email that there is, “need for further development of orthodontic information e-resources.”

Martyn Cobourne, a professor of orthodontics at King's College London Dental Institute, warned by email that on the Internet, “medical information is uncensored, not peer reviewed and can often be plain wrong.”

Cobourne, who was not involved in the study, note that some websites advertise braces that will move teeth more quickly, despite a lack of any scientific evidence.

Although the recommendations for the upkeep of braces are not very contentious, Cobourne notes that for more controversial issues, unreliable information can be very damaging for patients.

The best bet is for people to use official sites from national orthodontic societies, Cobourne said.

Livas advises patients to consult their orthodontists, who may refer them to “valid Internet patient education materials.”