This umbrella review investigated the methods and tools used for periodontal self-care in patients with healthy periodontium undergoing orthodontic treatment with fixed appliances. It aimed to summarize self-care recommendations, evaluate their effects on periodontal outcomes, and provide evidence-based guidance. The study followed a pre-registered protocol on PROSPERO (CRD42022367204) and adhered to PRISMA guidelines. English-language systematic reviews without date limits were searched up to 21 November 2022 in PROSPERO, Cochrane Library, Web of Science, Scopus, and MEDLINE/PubMed. Quality assessment was performed using AMSTAR 2. Seventeen systematic reviews were included. Results indicated that powered and manual toothbrushes perform similarly in controlling dental biofilm, although powered brushes may provide short-term improvements in gingival inflammation, bleeding, and probing depth. Chlorhexidine mouthwashes were effective as adjuncts to brushing for biofilm and inflammation control, whereas gels, varnishes, and pastes showed limited benefit. Herbal and natural agents, including aloe vera and chamomile, demonstrated antimicrobial activity comparable to chlorhexidine but with fewer side effects. Behavioral interventions and motivational techniques were also beneficial for maintaining oral hygiene, while current evidence does not support the use of probiotics in this context.
