Combined effects of repeated oral hygiene motivation and type of toothbrush on orthodontic patients: A blind randomized clinical trial

Objective:To investigate the effects on plaque index (PI) scores of manual or electric toothbrush with or without repeated oral hygiene instructions (OHI) and motivation on patients wearing fixed orthodontic appliances.Materials and Methods:One month after the orthodontic fixed appliance bonding on both arches, 60 patients were randomly assigned to four groups; groups E₁ (n  =  15) and E₂ (n  =  15) received a powered rotating-oscillating toothbrush, and groups M₁ (n  =  15) and M₂ (n  =  15) received a manual toothbrush. Groups E₁ and M₁ received OHI and motivation at baseline (T0) and after 4, 8, 12, 16, and 20 weeks (T4, T8, T12, T16, and T20, respectively) by a Registered Dental Hygienist; groups E₂ and M₂ received OHI and motivation only at baseline. At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI.Results:In all groups the PI score decreased significantly over time, and there were differences among groups at T8, T12, T16, and T20. At T8, PI scores of group E₁ were lower than those of group E₂, and at T12, T16, and T20, PI scores of groups M₁ and E₁ were lower compared to those of groups M₂ and E₂. A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant, independently from the use of manual or electric toothbrush.Conclusions:The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients, independent of the type of toothbrush used.