Oral Hygiene Compliance in Orthodontic Patients Using Active Reminders

Study Overview
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Brief Summary
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The aim of the present study will be to determine if different forms of active reminders regarding oral hygiene compliance have an influence on the level of compliance within orthodontic patients

Official Title
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Oral Hygiene Compliance in Orthodontic Patients Using Active Reminders: A Randomized Controlled Clinical Trial

Conditions
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Oral Hygiene, Dental Plaque

Intervention / Treatment
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* Other: WhatsApp reminders
* Other: Instagram reminders
* Other: Phone calls
* Other: Application alerts


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects with a complete natural dentition. Patients who need to undergo orthodontic therapy using fixed appliances. Good oral hygiene, with no signs and symptoms of periodontal disease. Patients with no medical or mental problems. Exclusion Criteria: Patients with health risks associated with periodontal probing. Syndromic patients ex; Down syndrome. Previous orthodontic treatment. Patients with carious teeth

Ages Eligible for Study
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Minimum Age: 11 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: WhatsApp messages<br> | Other: WhatsApp reminders<br>* Patients will receive active oral hygiene reminders in the form of WhatsApp messages one weekday each week. The standardized text message will be: This is a message from the Orthodontic Clinic at Faculty of Dentistry, Alexandria reminding you that it is extremely important to brush your teeth for 2 minutes after every meal or at least 3 times daily. Cleaning your teeth will help to keep them healthy and beautiful.<br>|
| Experimental: Instagram messages<br> | Other: Instagram reminders<br>* Patients will receive active oral hygiene reminders in the form of Instagram messages one weekday each week. The standardized text message will be: This is a message from the Orthodontic Clinic at Faculty of Dentistry, Alexandria reminding you that it is extremely important to brush your teeth for 2 minutes after every meal or at least 3 times daily. Cleaning your teeth will help to keep them healthy and beautiful.<br>|
| Experimental: Phone calls<br> | Other: Phone calls<br>* Patients will receive active oral hygiene reminders in the form of phone calls one weekday each week. The structured phone call will be: This is a message from the Orthodontic Clinic at Faculty of Dentistry, Alexandria reminding you that it is extremely important to brush your teeth for 2 minutes after every meal or at least 3 times daily. Cleaning your teeth will help to keep them healthy and beautiful.<br>|
| Active Comparator: App alerts<br> | Other: Application alerts<br>* Patients will download an app on their mobile phones which has cleaning tips, demonstrations and alerts. The structured message will be: This is a message from the Orthodontic Clinic at Faculty of Dentistry, Alexandria reminding you that it is extremely important to brush your teeth for 2 minutes after every meal or at least 3 times daily. Cleaning your teeth will help to keep them healthy and beautiful.<br>|
| No Intervention: No active reminders<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gingival bleeding | This will be assessed using the bleeding index (BI) upon probing the mesio-buccal, direct buccal, and disto-buccal aspects of the gingival sulci of the teeth. BI scoring ranges from 0-2; 0: no bleeding after 30 seconds, 1: bleeding after 30 seconds, 2: immediate bleeding | up to 6 months | 
| Gingival inflammation | This will be assessed using the modified gingival index (MGI). One MGI measurement of the buccal marginal gingiva for each tooth will be scored. Scoring ranges from 0-4 where 0 indicates absence of inflammation, 1: mild inflammation (marginal or papillary unit), 2: mild inflammation (entire marginal and papillary unit), 3: moderate inflammation, and 4: severe inflammation | up to 6 months | 
| Plaque accumulation | This will be assessed using the plaque index (PI). One PI measurement will be recorded for the buccal surface of each tooth. Scoring ranges from 0-5; where 0 indicates absence of plaque, 1: discontinuous plaque band at gingival margin, 2: up to 1 mm continuous plaque band at gingival margin, 3: plaque band wider than 1 mm but less than 1/3 of the surface, 4: plaque band between 1/3 and 2/3 of the surface, and 5: plaque covering 2/3 or more of the surface | up to 6 months | 
| Visual examination of white spot lesions | The presence of white spot lesions located on the buccal surface gingival to the archwire will be examined visually on the maxillary and mandibular six anterior teeth after being air dried for 5 seconds. Scoring ranges from 0-3; where 0: no visible white spot or surface disruption, 1: visible white spot without surface disruption, 2: visible white spot with roughened surface, 3: visible white spot requiring restoration. | up to 6 months |