Objective To evaluate the effectiveness of a composite oral health promotion program designed to reduce dental plaque among persons with severe mental illness in a psychiatric institution. Methods A cluster randomized controlled study was carried out in chronic psychiatric wards of a general hospital in central Taiwan. Sixty-eight eligible male individuals admitted to 2 wards were randomly assigned to an experimental and a control group. Participants in the experimental group underwent an oral health promotion program that consisted of biweekly group education sessions, and a 12-week individual behavioral modification for oral hygiene course. The participants in the control group received usual care only. Dental plaque (measured by the Plaque Control Index) was examined by a single dentist before and after the experiment. Each participant responded to a questionnaire regarding oral health knowledge, attitude and behavior before and after the experiment. Results Fifty-eight individuals completed the study. Before the experiment, the plaque index was similar between the intervention group (68.9; N = 27) and the control group (69.8; N = 31). After the experiment, the plaque index was significantly better in the intervention group than in the control group (42.6 vs. 61.8; P < 0.001). Participants in the intervention group also demonstrated better oral health knowledge, attitude and behavior than those in the control group after the experiment. Conclusions A composite oral health promotion program using both group education and individual behavioral methods over a 12-week period was effective in both reducing dental plaque and improving the oral health knowledge of persons with severe mental illness in the institution. Trial registration: This study was retrospectively registered in Clinicaltrials.gov, with number NCT04464941, dated 7/7/2020. https://register.clinicaltrials.gov/RD103035018.

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Objective: To evaluate the effectiveness of a composite oral health promotion program designed to reduce dental plaque among persons with severe mental illness in a psychiatric institution. Methods: A cluster randomized controlled study was carried out in chronic psychiatric wards of a general hospital in central Taiwan. Sixty-eight eligible male individuals admitted to 2 wards were randomly assigned to an experimental and a control group. Participants in the experimental group underwent an oral health promotion program that consisted of biweekly group education sessions, and a 12-week individual behavioral modification for oral hygiene course. The participants in the control group received usual care only. Dental plaque (measured by the Plaque Control Index) was examined by a single dentist before and after the experiment. Each participant responded to a questionnaire regarding oral health knowledge, attitude and behavior before and after the experiment. Results: Fifty-eight individuals completed the study. Before the experiment, the plaque index was similar between the intervention group (68.9; N=27) and the control group (69.8; N=31). After the experiment, the plaque index was significantly better in the intervention group than in the control group (42.6 vs. 61.8; P<0.001). Participants in the intervention group also demonstrated better oral health knowledge, attitude and behavior than those in the control group after the experiment. Conclusions: A composite oral health promotion program using both group education and individual behavioral methods over a 12-week period was effective in both reducing dental plaque and improving the oral health knowledge of persons with severe mental illness in the institution.

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A maxillary transverse deficiency is a common craniofacial problem. Rapid palatal expansion (RPE) has been traditionally considered for the treatment of children and young adolescents, but this is not applicable in late adolescents or adults due to the ossification of facial sutures. A surgically assisted rapid palatal expansion (SARPE) was initially advocated for this group of patients, but the surgical procedure is associated with morbidity. As temporary anchorage devices (TADs) have been recently and popularly applied in clinical orthodontics, micro-implant-assisted rapid palatal expansion (MARPE) has been employed to facilitate maxillary expansion in skeletally mature patients. There have been various proposed MARPE designs and the outcomes appear promising. The aim of the present article is to discuss the role of MARPE in clinical orthodontics by reviewing its background, design, indications, treatment effects, stability, and limitations in the current literature. The treatment effects of two types of MARPE, bone-borne and tooth-bone-borne (hybrid), will be individually assessed.