Abstract

Design: This is a randomized cohort study.

Cohort selection: The inclusion criteria comprised patients aged 14-19 years who started their orthodontic treatment using fixed appliances at the Orthodontic Clinic at Universidade Cruzeiro do Sul, San Paulo, Brazil. Only patients who had smartphones were included in this study. The exclusion criteria comprised patients who had previous orthodontic treatment, presence of any oral pathology, and chronic use of analgesic medication or presence of syndromes. Included patients were randomized to two groups (control and experimental).

Data analysis: The oral hygiene of the included patients was evaluated clinically at five points in time: before bonding fixed orthodontic appliance (T0), immediately after randomization (T1), at 30 days after the beginning of the intervention (T2), at 60 days after the beginning of the intervention (T3), and at 90 days after the beginning of the intervention (T4). Oral hygiene was assessed using visual plaque index (VPI) and gingival bleeding index (GBI) at six sites of all teeth in every arch excluding third molars. Prior to the intervention, all patients who participated in this study underwent an oral hygiene session aimed to obtain a plaque index equal to zero and were given standardized oral hygiene instructions. Patients included in the control group were not given any structured oral hygiene follow-up in addition to the standard follow-up already established at the orthodontic clinic. Patients in the experimental group were instructed to install an application (A Dentista Cientista) that was designed especially for this study on their smartphones. This application aimed to guide and motivate patients daily in a playful way about performing oral hygiene practices. The application reminded the patients to perform their oral hygiene through an alarm.

Results: A total of 11 patients were screened for study eligibility; 3 patients were excluded from the study. Eight patients were included in this study, four patients in each group. Although VPI and GBI values were reduced at T1 and T2 in the experimental group, there were no statistically significant differences for VPI and GBI between the groups at any time evaluated (P > 0.05). The patients who were included in the experimental group reported a good acceptability of the application and they would recommend it to other people. In addition, the patients who were included in the experimental group agreed that oral hygiene is crucial and 75% of them agreed that the application encouraged them to take better care of their oral health.

Conclusions: This study showed that mobile applications might help in improving the oral hygiene of orthodontic adolescent patients.