Oral hygiene behaviour changes in fixed orthodontic patients with the use of a mobile app: a randomised controlled trial

Abstract

Orthodontic fixed appliance treatment provides many benefits to patients in terms of improvement of occlusion and function, but the components of the appliance make it challenging for patients to maintain good oral hygiene. Therefore, it is imperative that oral hygiene instructions (OHI) be given to patients to ensure that they know how to care for their oral health while undergoing orthodontic treatment. Traditionally, OHI were given verbally, supplemented with pamphlets and demonstrations on models. The digital revolution has seen the incorporation of technology in healthcare such as the use of smartphone apps for patient education. Previous studies have shown positive improvements in oral health status with the use of a mobile app to reinforce oral hygiene. This research aimed to assess the effectiveness of mobile app conveyed oral hygiene and post bond up instructions compared to conventional chair-side instructions in fixed orthodontic patients. 66 subjects were recruited in this randomized control trial and divided equally into two groups. The control group was given conventional verbal chairside instructions and the intervention group was given mobile app-based instructions. The oral hygiene behaviour (OHB) and oral health status were assessed between both groups using a questionnaire and clinical examination. These were conducted at baseline (T0), 1 month (T1), 3 months (T2), and 6 months (T3). The results showed that the mean rank of OHB score was significantly higher in the control group but only at T1 (mean rank=38.95) compared to the intervention group (mean rank=28.05). However, the knowledge on caring for fixed appliance score was significantly higher in the intervention group at T1 and T2 (mean rank=40.42;38.74) compared to the control group (mean rank=26.58;28.26). There were no statistically significant differences between both groups in terms of oral health status at all intervals. The multiple regression analysis revealed that gender and age influenced OHB at baseline and T1 respectively. However, there was insufficient statistical evidence (F-test) to support that gender and age have any influence on OHB. Thus, the use of a mobile app can be an alternative to verbal instructions to provide oral health knowledge to patients undergoing orthodontic fixed appliance treatment.