Combined Efficacy of Advanced Oral Hygiene 
Aids and Active Reminders in Maintaining 
the Oral Hygiene of Patients with Fixed Orthodontic Appliances: A Randomized 
Clinical Trial

Abstract

Objectives: To evaluate the efficacy of water irrigating devices, powered toothbrushes, and active repeated oral hygiene reminders on oral hygiene of fixed orthodontic patients. Materials and Methods: This was a randomized, examiner-blind clinical trial involving fixed orthodontic appliance patients. Patients were recruited within six months of bonding on both the arches. Eighty patients were randomly assigned to four groups; groups 1 and 3 subjects received standard oral hygiene procedures and used manual orthodontic toothbrushes, and subjects in groups 2 and 4 used powered toothbrushes and water irrigators for oral hygiene maintenance during the study period. In addition, repeated oral hygiene reminders via SMS were sent to subjects in groups 1 and 2, whereas groups 3 and 4 subjects received only oral motivation. The principal investigator assessed the plaque index (PI) and gingival index (GI) at baseline (T0) and after 2, 4, 8, and 12 weeks, that is, T1, T2, T3, and T4, respectively. Results: Group 2 and group 4 subjects showed statistically significant reduction in PI ( p < .001) and GI ( p < .001) scores at the end of study interval; however, the magnitude of decrease was less in group 4 in comparison to group 2. Intergroup comparisons between group 1 versus group 3 and group 2 versus group 4 were made to evaluate the efficacy of reminders. Statistically significant reduction was observed in group 2 as compared to group 4 at T4 ( p < .001) when compared to T1 ( p < .87). Conclusion: Using powered toothbrushes and oral irrigators resulted in a statistically more significant reduction in plaque and gingivitis scores than conventional procedures. Active reminders had a catalytic effect in improving the oral hygiene.