How effective are three methods of teaching oral hygiene for adolescents undergoing orthodontic treatment? The MAHO protocol: an RCT comparing visual, auditory and kinesthetic methods

Abstract

Background Fixed orthodontic appliances hamper oral hygiene procedures. The consequences are gingivitis and white spot lesions. Fifty to 70% of patients treated with braces encounter these problems. Their care in the USA represents an annual cost of five hundred million dollars. Initial education and motivation for oral hygiene depend on two categories of factors: firstly, practical prophylactic measures (instruments and medication, professional care) and secondly, the educational component: choice of communication technique, frequency, and nature of hygiene instructions. This trial aims to study this last component. Its main objective is to compare three methods’ effectiveness of oral hygiene education in adolescent patients treated with braces in terms of biofilm (plaque) control. The secondary objectives are the evaluation of these methods’ effectiveness regarding gingival inflammation and the maintenance of hygiene during the first 6 months of treatment. Methods This study is a prospective randomized controlled trial of superiority. It evaluates the effectiveness of three hygiene education techniques. A total of 90 patients from the University Hospital Center of Rennes will be randomized into 3 parallel groups with a 1:1:1 ratio. Each will benefit from a different educational method: oral and/or practical. The main outcome will be the average plaque index for each group after 6 months of treatment. Additional outcomes will be the average gingival index for each group and the plaque and gingival indices over 6 months. Discussion The effectiveness of preventive procedures for optimizing oral hygiene during orthodontics is based on ambiguous literature. As a result, it is difficult to draw conclusions and to translate them into everyday practice. Sixty-eight percent of the orthodontists support the development of guidelines for education. The aim of this study is to standardize methods of oral hygiene education during orthodontic fixed treatment. The purpose of this study would be to provide practitioners with a concrete education program through guidelines dedicated to the method having the best results. Trial registration ClinicalTrials.gov NCT04444154. Registered on 22 June 2020. SI CNRIPH ID 8011N° 20.04.27.58337. Registered on 29 July 2020

Orthodontic Retainers—A Critical Review

“…Fiberglass appears inferior compared to braided wire due to its increased thickness and the frequent delamination, which can end up being embarrassing [60]. The significance of patient support regarding effective oral hygiene maintenance should be well-established [103,104].…”

Influence of probiotics on the periodontium, the oral microbiota and the immune response during orthodontic treatment in adolescent and adult patients (ProMB Trial): study protocol for a prospective, double-blind, controlled, randomized clinical trial

“…Regarding plaque accumulation, we will use the modified plaque index (MPI) [ 66 ], since it allows to describe the amount of plaque not only in approximal areas like the approximal plaque index (API) [ 61 ], but also on the cervical area and around the bracket since additional plaque retention niches need to be evaluated in orthodontic patients and since probiotics reduced plaque accumulation [ 45 ]. To enable the reevaluation of the index and to ensure reproducibility, intraoral photographs [ 102 , 103 ] will be taken after staining of teeth. Since our study will focus on effects of fixed brackets, the GI [ 61 ], MPI [ 66 ] and PPD will be measured full-arch but only on teeth receiving fixed bonded orthodontic brackets.…”

Motivation of Adult Patients with Orthodontic Treatment in Maintaining Oral Hygiene

“…The results of the study showed that in Group 3 the values of the plaque index were lower compared to the other patients, due to the impact that the video presentation had on them. 31 The hygiene of adult patients wearing fixed orthodontic appliances can also be improved by presenting images of the severe consequences of biofilm accumulation. 32,33 CONCLuSIONS 1.…”