Orthodontic patients\u2019 oral hygiene compliance by utilizing a smartphone application (Brush DJ): a randomized clinical trial

Homa Farhadifard,Maryam Farhadian,Sepideh Soheilifar,Anahita Bakhshaei,Hadi Kokabi

doi:10.1038/s41405-020-00050-5

Homa Farhadifard, Maryam Farhadian + Show 3 more

Open Access

https://doi.org/10.1038/s41405-020-00050-5

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Journal: BDJ Open	Publication Date: Nov 20, 2020
Citations: 18	License type: open-access

Affiliation: Hamedan University of Medical Sciences

Abstract

Considering the widespread use of smartphones and their applications (apps), as well as the undeniable role of reminders and apps in behavioral interventions, this study aimed to assess the efficacy of a smartphone app (Brush DJ) for oral hygiene compliance of patients with fixed orthodontic appliances. In this randomized clinical trial, 120 patients between 15 to 25 years who had just started fixed orthodontic treatment were randomly divided into two groups (n = 60). Control patients received conventional oral hygiene instruction, while patients in the intervention group were asked to use the Brush DJ smartphone app, after receiving conventional oral hygiene instruction. The plaque index (PI) and gingival index (GI) were measured at baseline (T0), and at 4 weeks (T1), 8 weeks (T2) and 12 weeks (T3) after the onset of study. A questionnaire was given to all patients to assess the frequency and duration of tooth brushing per day, and the frequency of app usage and reminder noticing in the intervention group. Improvements in PI and GI were noted in the intervention group; while these parameters increased in the control group. Significant differences were noted in PI and GI changes between the two groups (p < 0.001). Brushing frequency and duration were positively correlated with app usage during the follow-up period. Ultimately, we believe that smartphone apps, as motivators and reminders, can greatly help in improving the orthodontic patients’ oral hygiene compliance, especially in adolescents

Highlights

Dental alignment facilitates oral hygiene, and can decrease the risk of caries and periodontal disease.[1]
Mechanical plaque removal can decrease the risk of chronic gingivitis, but many orthodontic patients do not have sufficient motivation for efficient dental plaque removal; this problem is more obvious in adolescent orthodontic patients.[4,5]
Since the results of t-test for plaque index (PI) at baseline did not show a significant difference between the intervention and control groups, repeated measures ANOVA was used for intergroup comparisons

Summary

Introduction

Dental alignment facilitates oral hygiene, and can decrease the risk of caries and periodontal disease.[1] bacterial plaque accumulation around orthodontic brackets can lead to development of white spot lesions during orthodontic treatment since fixed orthodontic appliances interfere with dental plaque removal.[2,3] Bacterial accumulation around the teeth can result in gingival inflammation, bleeding, oedema, and changes in gingival morphology and gingival crevicular fluid.[3] Mechanical plaque removal can decrease the risk of chronic gingivitis, but many orthodontic patients do not have sufficient motivation for efficient dental plaque removal; this problem is more obvious in adolescent orthodontic patients.[4,5]. Previous studies have revealed a rapid decline in oral hygiene status after the first session of orthodontic treatment followed by a rapid improvement at 5 months following the treatment onset.[6]. The poorest oral hygiene compliance has been reported at the end of treatment by some other studies.[7] achieving acceptable and sustainable oral hygiene remains a challenge in orthodontic patients.[3]

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