Influence of active reminders on oral hygiene compliance in orthodontic patients

Objective: To determine if text message reminders regarding oral hygiene compliance have an influence on the level of compliance within an orthodontic population.Materials and Methods:In this prospective, randomized, controlled clinical trial, 42 orthodontic patients were assigned to a text message or control group. Parents of patients assigned to the text message group received a reminder text message one weekday each week. Oral hygiene compliance was measured using bleeding index (BI), modified gingival index (MGI), and plaque index (PI), and visual examination of white spot lesion (WSL) development at baseline (T0), two appointments after baseline (T1), and four appointments after baseline (T2).Results:BI, MGI, and PI scores were significantly lower in the text message group than in the control group at T2.Conclusion:A text message reminder system is effective for improving oral hygiene compliance in orthodontic patients.     

The influence of text messaging on oral hygiene effectiveness

Objective:To investigate whether text message reminders regarding oral hygiene have an effect on plaque removal in orthodontic patients.Materials and Methods:In this randomized, controlled clinical trial, 50 orthodontic patients were assigned to either a text message or control group. Patients in the text message group received 12 text messages over the course of 4 weeks and one text message for 8 weeks thereafter. Photos were taken at baseline (T0), at 4 weeks after baseline (T1), and at 12 weeks after baseline (T2). For each subject, photos of eight teeth were taken and then the area of the tooth and amount of plaque were measured using planimetry.Results:There was a statistically significant difference in plaque coverage between baseline and both T1 and T2 in the text message group as measured using planimetry. This was demonstrated by comparing the average measurements of the control group and the treatment group.Conclusion:This study demonstrated that the use of automated text message reminders sent from an orthodontic office was effective in improving oral hygiene compliance in orthodontic patients.     

Effectiveness of metronidazole gel and mobile telephone short-message service reminders on gingivitis in orthodontic patients:: A double-blind randomized controlled trial

ObjectivesTo compare the effectiveness of metronidazole gel and mobile telephone short-message service (SMS) reminders on gingivitis in patients undergoing fixed orthodontic treatment.Materials and MethodsThe trial was double blinded (patient and investigator), and only the clinical trial unit pharmacist was unblinded. Data were collected from patients undergoing fixed orthodontic treatment for at least 6 months. A total of 66 patients were randomly assigned to either 0.8% metronidazole gel (n = 22), SMS reminder and placebo gel (n = 22), or placebo (control) group only (n = 22). Gingival index (GI), bleeding index (BI), and orthodontic plaque index (OPI) were evaluated on several teeth at baseline (T₀) and after 4 weeks (T₁). Paired-sample t-tests were used to compare mean differences of indexes at T₀ and T₁ in the groups, and independent-sample t-tests were used to determine the effects of interventions compared with the controls.ResultsData from 64 patients were analyzed; there were 2 dropouts. There were statistically significant (P < .05) reductions in GI, BI, and OPI scores from T₀ to T₁ for each intervention. However, there were no significant differences between each intervention and the control group. There were no adverse effects.ConclusionsThe null hypothesis could not be rejected. There is no difference between interventions (application of 0.8% metronidazole gel and SMS reminder for reinforcing oral hygiene) in reducing gingival inflammation in orthodontic patients.     

Can text messages encourage flossing among orthodontic patients?

ObjectivesTo assess the extent to which text messages on WhatsApp play a role in patient awareness of the importance of proper oral hygiene and flossing on a daily basis and to test the null hypothesis that daily text messages do not influence the flossing habits of orthodontics patients.Materials and MethodsForty-four patients wearing fixed orthodontic appliances with a mean age of 14.3 years participated in the study. Patients (male and female) were randomly assigned to two groups (n = 22): group 1, text messages sent via WhatsApp daily during the study period, and group 2 (control), no text messages received. Plaque index, gingival bleeding index, and halitosis were assessed at baseline and after 30 days. The results were analyzed and subjected to normality test, McNemar test, Fisher exact test, Mann-Whitney test, and Wilcoxon signed-rank test.ResultsThere was a significant influence on flossing habits (P < .05) and a significant reduction in plaque and gingival bleeding indices in group 1 (P < .05). Group 1 had a significant reduction in halitosis (P < .05).ConclusionsDaily text messages seem to influence patient awareness of the importance of proper oral hygiene and flossing. The null hypothesis was rejected because those patients who received text messages every day changed their flossing habits.     

The effect of using mobile applications for improving oral hygiene in patients with orthodontic fixed appliances: a randomised controlled trial

Objective: To investigate the effect of using mobile applications active reminders to improve oral hygiene in comparison to verbal oral hygiene instructions.

Design: Two-arm parallel randomised controlled trial.

Setting: orthodontic clinics at two branches of a university hospitals of the college of dentistry of Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia.

Participants: Forty-four 12-year-old and older subjects.

Method: Subjects undergoing orthodontic treatment with fixed appliances were randomly assigned to one of two groups using simple randomisation. Group I: subjects received a mobile application that sends active reminders of oral hygiene three times a day (n?=?22). Group II: subjects received verbal oral hygiene instructions verbally during their routine orthodontic visits (n?=?22). Two primary outcomes were assessed using plaque index (PI) and gingival index (GI) for Ramfjord teeth to evaluate the level of oral hygiene at baseline and after 4 weeks.

Results: Mean differences for PI and GI for group I were reduced from T1 to T2 (P?P?P?>?0.05, P?>?0.05). Both PI and GI significantly reduced for group I compared to group II between T1 and T2 (P?P?Conclusions: PI and GI all significantly decreased after 4 weeks of using active reminders of oral hygiene instructions on mobile application compared to verbal oral hygiene instructions.

The study was registered at clinicaltrials.gov with number: NCT03109769.     

Traditional vs digital communication channels for improving compliance with fixed orthodontic treatment:: A randomized controlled trial

ObjectivesTo compare the efficacy of traditional and digital communication strategies in improving compliance with fixed orthodontic therapy and to investigate the effect of gender, baseline oral hygiene habits, socioeconomics, and parents'' education on orthodontic compliance.Materials and MethodsOrthodontic patients were randomly allocated to three groups. Group 1 received traditional communication including verbal and written instructions, whereas group 2 and group 3 received, in addition to traditional communication, weekly text messages or e-mails with audiovisual links, respectively. Baseline demographics (age, gender, baseline oral hygiene habits, socioeconomics, and parents'' education) as well as compliance indicators (treatment duration, failed appointments, incidence and total number of appliance breakages) were recorded. For statistical analysis, Pearson chi-square, independent t-test, and one-way analysis of variance were used (P < .05).ResultsOf 120 patients (aged 12 to 18 years) recruited, 108 completed the trial (G1 = 37, G2 = 35, G3 = 36). Weekly text messages failed to improve patient compliance. On the other hand, sending weekly e-mails with audiovisual links significantly (P = .014) reduced the incidence of appliance breakage as compared with the control group. Females had a significantly lower incidence of breakage (P = .041) and a fewer total number of breakages (P = .021). Patients from households with high income had significantly better compliance (P < .05). A higher level of parents'' education was significantly associated with a lower incidence and total number of breakages (P < .01).ConclusionsCommunication with patients using link-rich e-mails and reminders could improve patient compliance with fixed orthodontic treatment. Female patients, high household income, and high parent education are associated with better compliance with fixed orthodontic treatment.     

Usefulness of an app in improving oral hygiene compliance in adolescent orthodontic patients

Objective:To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances.Materials and Methods:Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were randomly divided into two groups of 40. Plaque index (PI), gingival index (GI), white spots (WS), and caries presence were recorded in all patients, and they were instructed regarding domestic oral hygiene maintenance on the day of braces application (t₀) and every 3 months (t₁, t₂, t₃, t₄) during the first year of treatment. Study group (SG) patients were enrolled in a WhatsApp chat room–based competition and instructed to share monthly with the other participants two self-photographs (selfies) showing their oral hygiene status.Results:SG patient participation in the chat room was regular and active throughout the observation period. At t₂, t₃, and t₄, SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries, compared with the control group.Conclusion:Integration of new “social” technologies in a standard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and in improving their oral health status during orthodontic multibracket treatment.     

The influence of text messages on the cooperation of Class II patients regarding the use of intermaxillary elastics

Objectives:To evaluate the influence of text messages on cooperation of Class II patients with the use of intermaxillary elastics.Materials and Methods:The sample consisted of 42 orthodontic patients (20 males and 22 females) aged between 14 and 34 years. They were randomly divided into one of the following two groups: a control group with 21 patients who did not receive messages and an experimental group with 21 patients who received motivational and reminder text messages. Messages were sent twice a week for a period of 3 months. The patients were instructed to wear the elastics all day, removing them only during meals and replacing them daily. All patients were instructed regarding the importance of cooperation. Measurements were performed with a digital caliper on plaster models at the beginning of elastics wear (T1) and 3 months later (T2). For intragroup and intergroup comparisons between T1 and T2, paired and unpaired t-tests, respectively, were used with a significance level of 5%.Results:Statistically significant differences were observed in the intra- and intergroup comparisons between T1 and T2. Both groups showed a decrease in the sagittal distance between upper and lower arches from T1 to T2, demonstrating the effective use of elastics. However, the experimental group showed a Class II correction that was 3.7 times greater than the control group (P = .001).Conclusions:Text messages had a positive influence on the cooperation of patients regarding the use of intermaxillary elastics in the orthodontic treatment of Class II malocclusion.     

Urea peroxide solution in the treatment of gingivitis in orthodontics.

A 3-month study was conducted to determine the effect of a 10 per cent urea peroxide solution on gingivitis and oral debris accumulation in orthodontic patients. Sixty fullybanded children (thirty-two girls, twenty-eight boys) 10 to 17 years of age were randomly placed into two groups of thirty members. The treatment group was assigned the use of the test solution and given normal oral hygiene instructions. The control group was given only the normal oral hygiene instructions. The subjects' gingival status was evaluated by means of the gingival index (GI) of O'Leary. The accumulation of oral debris was monitored by means of the oral debris index (ODI) of Greene and Vermillion as modified by Womack. Subjects were scored at the start of the study and approximately 1 and 3 months thereafter. Analysis of variance of the GI and ODI scores revealed significant treatment effects (p = 0.0013 and p = 0.0051, respectively), which substantiated the clinical observations. Rinsing with the test solution in conjunction with toothbrushing appears useful as an oral hygiene measure for orthodontic patients. No adverse reactions were experienced by any of the patients using the test solutions.     

Listerine~漱口水对固定矫治患者牙周及牙菌斑影响的临床研究

目的观察Listerine漱口水对固定矫治患者牙周及牙菌斑的影响。方法选择30例固定矫治患者,年龄12～25岁,随机分成实验组和对照组,实验组使用Listerine漱口水漱口,对照组不使用漱口水。分别测量治疗初,3个月,6个月时的菌斑指数（PLI）,牙龈指数（GI）,出血指数（BI）。应用SPSS10．0统计软件,采用Student-newman-Keuls比较不同时间各指数间的差异。采用t检验比较同一时间同一指数实验组和对照组间的差异。以P≤0．05为有统计学意义。结果实验组在3个月,6个月时BI,PLI,GI升高缓慢,无统计学意义。实验组在3个月和6个月时的PLI,GI,BI值明显低于对照组,且有统计学差异,PLI：（P〈0．01）,GI：（P〈0．01）,BI：（P〈0．001）。6个月时对照组同实验组间的PLI,GI,BI也有明显的统计学差异（P〈0．001）。结论使用Listerine漱口水可以明显减少固定矫治患者的牙菌斑及牙龈炎的发生发展,有利于患者保持口腔卫生。     

Oral Hygiene Behavior of Croatian Adolescents during Fixed Orthodontic Treatment: A Cross-sectional Study

ObjectiveTo investigate the impact of fixed orthodontic treatment on adolescents'' oral hygiene behavior and to examine their food consuption during fixed orthodontic treatment, as well as their motivation to maintain oral hygiene.Materials and methodsThis research was carried out in a form of a survey questionnaire consisting of 23 questions. The sample comprised 170 adolescent patients aged from 11 to 19 who underwent the fixed orthodontic treatment at the Orthodontic Clinic of the Zagreb University Hospital Centre.ResultsThe orthodontic appliance did not interfere with the patients’ maintenance of oral hygiene, but it made the consumption of certain foods more difficult. Most adolescents brushed their teeth twice a day, using medium-soft brushes (35%). Regarding additional oral hygiene aids, 72.4% of the respondents used interdental brushes, more than 50% of the respondents used antiseptic mouthwashes for mouth rinsing, whereas only 31.2% of the tested population used dental floss (4.1% of which daily). The respondents were highly motivated to maintain oral hygiene by their orthodontists (96.5%), but only a small number of the respondents were informed about the importance of an adequate diet while undergoing a fixed orthodontic treatment.ConclusionOrthodontists should provide their patients with detailed instructions on hygiene maintenance and adequate diet during orthodontic treatment to minimize negative side effects of the fixed orthodontic treatment. Patients should be motivated upon each follow-up examination and encouraged to use as many oral hygiene aids in their daily routines as possible.     

A Comparison Between Written,Verbal, and Videotape Oral Hygiene Instruction for Patients with Fixed Appliances

Abstract

The objective of the study was to compare the effectiveness of written, videotape, and one-to-one instruction upon the knowledge, oral hygiene standard, and gingival health of subjects undergoing orthodontic treatment with a lower fixed appliance.

Subjects for whom fixed appliances had been fitted recently were divided randomly into three groups of 21, 22, and 22, respectively. Group 1 received written oral hygiene instruction, group 2 a specially made videotape, and group 3 saw a hygienist for one-to-one instruction. Results were assessed in terms of improvement in knowledge concerning oral hygiene procedures, and of plaque and gingival index scores.

Analysis of variance revealed no significant main effects or interactions at P = 0?05, although the difference in the plaque index scores before and after instruction was close to significance.     

Assessing the effectiveness of text messages as appointment reminders in a pediatric dental setting

BackgroundText messaging is a dominant form of communication in our society. However, little research has been conducted to evaluate its effectiveness as an appointment reminder in the dental setting.MethodsFrom the patient pool of the pediatric dentistry clinic at the University of Washington, Seattle, the authors invited 543 caregiver/child dyads who met eligibility criteria to participate in this study. They randomly assigned 318 pairs (59 percent response) to receive a short message service (SMS) text message (n = 158) or a voice message (control group) (n = 160) as an appointment reminder.ResultsYounger caregivers were more likely to be nonattendees than were older caregivers (P = .02). Participants in the voice message group had a lower no-show attendance (8.2 percent) than did those in the text message group (17.7 percent) (P = .01). The unadjusted odds ratio (OR) for type of appointment reminder and no-show attendance was 2.41 (P = .01). After the authors adjusted for the caregiver's age, the OR was 2.12 (P = .04).ConclusionsSMS text messages were not as effective as voice reminders for patients in a dental school pediatric dentistry clinic. Future studies should investigate the effect of text message reminders when limited to patients who self-select that type of reminder and in patient populations outside the university setting.Clinical ImplicationsText messaging may not be the preferable method of reminding patients about appointments in a university pediatric dental clinic.     

Effect of text message follow-up on patient's self-reported level of pain and anxiety

Objectives:To determine whether a text message reduces the severity of patient self-reported levels of pain and anxiety following initial placement of orthodontic appliances.Materials and Methods:Thirty-nine orthodontic patients were randomly assigned to one of two groups and matched for age, gender, and bracket type (self-ligating vs conventional). The subjects completed baseline questionnaires to ascertain their levels of pain and anxiety before initiating orthodontic treatment. Following the initial appointment, subjects completed the pain questionnaire and anxiety inventory at the same time daily for 1 week. One group received a structured text message showing concern and reassurance, while the second group served as a control and received no postprocedural communication.Results:There was a statistically significant difference in pain in relation to time between the text message group and the control group as it was demonstrated that demonstrated that compared with the text message group, mean pain intensity increased and selfreported discomfort was longer in the control group. Anxiety was determined to be at its peak the day following initial orthodontic appliance placement and gradually tapered off from that time point. No intergroup difference was noted when analyzing anxiety.Conclusions:This study demonstrated that a text message sent from an orthodontic office following initial appliance placement resulted in a lower level of patient''s self-reported pain. Additionally, patient anxiety is at its peak the day following the initial appointment and decreases from that point forward.     

个体化口腔卫生强化教育对固定矫治的青少年患者口腔卫生的影响

目的：探讨个体化口腔卫生强化教育对固定矫治的青少年患者口腔卫生的影响.方法：11～15岁的正畸初诊患者80例随机分为实验组和对照组各40例,实验组进行个体化口腔卫生强化教育,由口腔医生对学生进行个体化的口腔强化教育和有效刷牙教育,并同时得到家长和老师的监督;对照组进行一般口腔卫生知识宣教,不采取任何干预措施.记录两组治疗前后的正畸菌斑指数（PLI-O）和牙龈出血指数（BI）.结果：3个月后个体化口腔卫生强化教育组青少年患者的正畸菌斑指数（PLI-O）和牙龈出血指数有显著差异（P＜0.05）.结论：个体化口腔卫生强化教育对改善正畸青少年口腔卫生状况有显著作用.     

Failed appointments in an orthodontic clinic.

BACKGROUND: The aim of this study was to retest the hypotheses of Reekie and Devlin (1998) by conducting a similar randomized controlled trial in an orthodontic clinic in the Netherlands. It was hypothesized that a reminder would reduce the failed attendance rate and that the form of the reminder would be irrelevant. METHODS: All patients with appointments in the orthodontic clinic at the Academic Centre of Dentistry Amsterdam during a 3-week period were divided into 4 groups. Three groups received a reminder 1 day before the appointment, either by telephone, mail, or short message service (SMS, a service used to send and receive short text messages to and from cell phones). A control group did not receive a reminder. In a follow-up study, random subsamples in each group were interviewed by telephone. Subjects were asked how they felt about receiving a reminder and which reminder they preferred. RESULTS: The hypothesis that a reminder would reduce the failed attendance rate was not confirmed. Also, no differences were found between the 4 conditions, indicating that the form of the reminder is irrelevant. However, most of the interviewed participants felt positive or very positive about receiving a reminder. There was a significant preference for a reminder by mail (56.3%), followed by a telephone reminder (26.0%) and a reminder by SMS (17.7%). No less than 20% of the interviewed participants felt negative or very negative about the reminders and considered them to be a waste of time and money. CONCLUSIONS: The hypothesis that reminders are useful in the prevention of failed appointments was not confirmed. This study underlines the importance of replication studies. It demonstrates that every research result, whether it is generated by evidence-based or tradition-based research, should be interpreted with care and should be replicated in other studies before the results can be generalized.     

Comparison of the plaque removal efficacy of a new flossing aid (Quik Floss®) to finger flossing

Abstract The purpose of this clinical trial was to compare the effectiveness and safety of a new dental flossing device (Quik Floss®) to finger flossing in plaque removal, reduction of gingival inflammation and patient preference. 30 healthy, non-flossing adults with 20 natural teeth, a plaque index (PI) of at least 1.8 and a gingival index (GI) of 1.3 or greater participated in this two-phase crossover design study. Patients were randomly assigned to use either the new flossing device or finger flossing first in the sequence. At baseline, data were collected and patients were given flossing method instructions. The Silness & Löe GI, Quigley-Hein PI, Eastman Bleeding Index (BI) and trauma were assessed at baseline. 15 and 30 days for each treatment period. After the initial 30-day treatment phase, patients were instructed to cease all flossing during a 14-day “washout” period. Subjects were then assigned to the opposite treatment group during the 2nd treatment phase. A 3-factor repeated measures ANOVA analyzed data for differences within and between groups over time. Results revealed statistically significant (p < 0.01) within group improvement in PI, GI, and BI for both treatment groups over time. No statistically significant between group differences were found for either group at any time period. In addition, no significant gingival trauma was recorded and no differences were found between groups. Quik Floss® was as effective as finger flossing. Subjects preferred (55%) Quik Floss® over finger flossing. In conclusion, Quik Floss® is a safe and effective oral hygiene measure for reducing plaque, inflammation and bleeding over time.     

Effectiveness of an essential oil mouthrinse in improving oral health in orthodontic patients

OBJECTIVE: To test the null hypothesis that adding Listerine mouthrinse to the standard oral hygiene regimen has no added benefit for orthodontic patients in maintaining proper oral health. MATERIALS AND METHODS: Patients within their first 6 months of orthodontic treatment were assigned either to the brushing + flossing (N = 25) or brushing + flossing + Listerine (N = 25) group. Initially, all of the participants received a prophylaxis and instructions on how to brush and floss. Measurements were recorded for the bleeding, gingival, and plaque indices (BI, MGI, and PI, respectively) that provided baseline values (T1). Subsequent measurements were taken at 3 months (T2) and 6 months (T3). Mean BI, MGI, and PI at T1, T2, and T3 were compared statistically between the groups using repeated measures analysis of variance. The significance level was set at P < or = .05. RESULTS: The response profiles for the BI, MGI, and PI over time were significantly different between the two groups. Patients who had Listerine in their daily oral hygiene regimen exhibited significantly lower scores for all three indices at T2 and T3 than the patients who only brushed and flossed. CONCLUSIONS: The hypothesis is rejected. This study shows that use of Listerine mouthrinse can reduce the amount of plaque and gingivitis in patients undergoing orthodontic treatment. Adding Listerine to the standard oral hygiene regimen may be beneficial for orthodontic patients in maintaining proper oral health, thus reducing the likelihood that white spot lesions and gingivitis will develop.     

An orthodontic tooth brushing technique to enhance oral hygiene in patients wearing fixed orthodontic appliances: A randomized controlled trial

Background

An effective tooth brushing technique is essential in maintaining oral hygiene, especially for patients wearing fixed orthodontic appliances. Traditional tooth brushing techniques are mainly designed for the general population without orthodontic appliances, which may not account for the oral condition of orthodontic patients due to the increased biofilm formation. The aim of this study was to design an orthodontic tooth brushing technique and compare its effectiveness with the traditional modified Bass technique.

Methods

Sixty patients wearing fixed orthodontic appliances were included in this two-arm paralleling randomized controlled trial. Thirty patients were assigned to the modified Bass technique group and 30 patients were assigned to the orthodontic tooth brushing technique group. The orthodontic tooth brushing technique involved a biting motion on the head of toothbrush in order to place the toothbrush bristles behind the archwires and around the brackets. Plaque index (PI) and gingival index (GI) were used to assess oral hygiene. Outcome measurements were taken at baseline and 1 month after the intervention.

Results

The new orthodontic tooth brushing technique significantly reduced PI (average PI reduction = 0.42 ± 0.13), especially in the gingival (0.53 ± 0.15) and interproximal (0.52 ± 0.18) areas (p < 0.05 for all). No significant reduction was found for the GI (p > 0.05 for all).

Conclusion

The new orthodontic tooth brushing technique showed a promising result in reducing PI in patients wearing fixed orthodontic appliances.