ObjectiveTo evaluate the effectiveness of the WhiteTeeth mobile app, a theory‐based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients.MethodsIn this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check‐ups: at baseline (T0), at 6‐week follow‐up (T1) and at 12‐week follow‐up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n = 67). The control group received usual care only (n = 65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al‐Anezi and Harradine plaque index), and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behaviour and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed‐model analyses to determine the intervention effects.ResultsAt 6‐week follow‐up, the intervention led to a significant decrease in gingival bleeding (B = −3.74; 95% CI −6.84 to −0.65) and an increase in the use of fluoride mouth rinse (B = 1.93; 95% CI 0.36 to 3.50). At 12‐week follow‐up, dental plaque accumulation (B = −11.32; 95% CI −20.57 to −2.07) and the number of sites covered with plaque (B = −6.77; 95% CI −11.67 to −1.87) had been reduced significantly more in the intervention group than in the control group.ConclusionsThe results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.

The incidence of dental caries in the primary dentition was determined in Dutch cleft lip and/or palate children (n = 81) and in children without a congenital malformation (n = 77). In the oral cleft group the incidence of dental caries (0.037; 95% CI 0.031–0.046) was significantly higher than in the control group (0.004; 95% CI 0.002–0.007) with a crude incidence rate ratio of 9.3. Adjusted for oral hygiene, oral cleft yielded a rate ratio (relative risk) of approximately 3.5 (95% CI 1.35–9.28) in the multivariate analysis. Dental caries occurred in 25 children with an oral cleft (30.9%) and in 5 control children (6.5%). All types of teeth were affected in the oral cleft group while in the control group dental caries only occured in maxillary incisors and second molars. The highest incidence of dental caries was found in the teeth beside the oral cleft and in the primary molars of the oral cleft group.

The prevalence of dental caries was determined clinically in 2.5-year-old Dutch cleft lip and/or palate children (n = 76) and in children without congenital malformation (n = 75). The parents were given a structured questionnaire regarding the child's dietary habits, oral hygiene, fluoride exposure and social economic background. The prevalence of dental caries was higher in children with oral cleft than in children without oral cleft. Initial caries (white spots) was diagnosed in 17.1% of the subjects with oral cleft compared with 4.0% of the control subjects. Manifest caries (cavities) was found in 26.3% of the children with oral cleft compared with 5.3% of the controls. The dft score (manifest caries) was significantly higher for the oral cleft group (0.59 +/- 1.35) than for the control group (0.11 +/- 0.54). 52% of the total number of initial and manifest lesions were localized to the maxillary incisors. A multivariate analysis yielded initial caries, oral hygiene and treatment with preoperative infant orthopaedics as the variables significantly associated with manifest caries.

This study concerns palatal development during 6 months following primary lip closure. The sample consisted of 75 children with different forms of cleft lip and palate and 51 noneleft children. The palate was measured at 3 months of age, just before lip surgery, after surgery at 6 months, and again at 9 months of age. The results showed that lip closure has a strong effect in the anterior alveolar region. This effect was restricted to 3 months after surgery. The changes in complete clefts were more explicit than in incomplete cleft forms. Furthermore, the data showed that arch depth reduction due to lip surgery was compensated for by continued anteroposterior palatal growth. Early orthopedics appeared to prevent major palatal collapse immediately after lip surgery. Finally simultaneous closure of the alveolar cleft at the nasal side resulted in continued reduction of anterior cleft width.