Evaluation of the Effects of a Mobile Application on Oral Hygiene Motivation and Compliance with Fixed Orthodontic Patients

Hikmet Guliyev; Baris Baser

EN TR

Evaluation of the Effects of a Mobile Application on Oral Hygiene Motivation and Compliance with Fixed Orthodontic Patients

Abstract

Objectives: The aim of this study is to evaluate the effects of a uniquely developed mobile app on oral hygiene motivation and treatment compliance in patients undergoing fixed orthodontic treatment in comparison to traditional oral hygiene instructions. Materials and Methods: In this prospective, controlled clinical trial, 50 orthodontic patients having fixed treatment were equally divided into two groups: a mobile app (e-tel (ortomobil)) and a control group. The control group received only traditional communication, consisting of verbal and written instructions at the start of treatment. Patients assigned to the mobile app group were provided with the ability to reschedule their appointments via the app, engage in direct chat with their orthodontist, and receive periodic notifications to remind them of oral hygiene motivation in addition to standardized hygiene instructions. Periodontal scores were obtained at 4 week intervals during three appointments (T1-T3) using the gingival index (GI), bleeding index (BI), and planimetric plaque quantification (PI) on photographs. Student’s t-test and Mann Whitney U test were used for intergroup comparisons and evaluation of repeated measurements (p<0.05). Results: GI and BI scores were significantly lower in the mobil app group than in the control group at T3 (p =0.001, p < 0.01). The PI scores did not show a statistically significant result at the end of the third month (p> 0.05). The use of mobile app increased patients' compliance. Conclusions: A uniquely developed mobile app effectively maintained the oral hygiene motivation of patients undergoing fixed orthodontic treatment and contributed to an improvement in their treatment compliance.

Keywords

Sabit Ortodontik Tedavi Gören Hastalarda Bir Mobil Uygulamanın Ağız Hijyeni Motivasyonu ve Uyum Üzerindeki Etkilerinin Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı, özgün olarak geliştirilen bir mobil uygulamanın sabit ortodontik tedavi gören hastalarda ağız hijyeni motivasyonu ve tedavi uyumu üzerindeki etkilerini geleneksel ağız hijyeni talimatlarıyla karşılaştırarak değerlendirmektir. Materyal ve Metot: Bu prospektif, kontrollü klinik çalışmada, 50 sabit ortodontik tedavi hastası eşit şekilde mobil uygulama (Ortomobil (e-tel)) ve kontrol grubu olmak üzere ikiye ayrıldı. Kontrol grubu, tedavinin başlangıcında sadece sözlü ve yazılı talimatlardan oluşan geleneksel iletişim aldı. Mobil uygulama grubuna atanan hastalara, randevularını uygulama üzerinden yeniden planlama, ortodontistleriyle doğrudan iletişimde olabilme ve standart hijyen talimatlarına ek olarak ağız hijyeni motivasyonunu belirli aralıklarla hatırlatan bildirimler alma imkanı sağlandı. Periodontal skorlar, 4 haftalık aralıklarla, ardışık üç randevu (T1-T3) sırasında gingival indeks (GI), kanama indeksi (BI) ve fotoğraflardan elde edilen planimetrik plak miktarı (PI) ölçülerek elde edildi. Gruplar arası karşılaştırmalar ve tekrarlanan ölçümlerin değerlendirilmesi için Student’s t-testi ve Mann Whitney U testi kullanıldı (p<0,05). Bulgular: Mobil uygulama grubundaki GI ve BI skorları, kontrol grubuna göre T3'te (p = 0,001, p < 0,01) anlamlı şekilde daha düşük bulundu. Üçüncü ayın sonunda PI skorları istatistiksel olarak anlamlı bir sonuç göstermedi (p > 0,05). Mobil uygulamanın kullanımı hastaların tedavi uyumunu artırdı. Sonuç: Özgün olarak geliştirilen bir mobil uygulama, sabit ortodontik tedavi gören hastaların ağız hijyeni motivasyonunu etkili bir şekilde sürdürebilmesine ve tedavi uyumlarının artmasına katkıda bulundu.

Anahtar Kelimeler

Supporting Institution

Karadeniz Technical University Scientific Research Projects

Project Number

9623/2021

References

1. Eppright M, Shroff B, Best AM, et. al. Influence of active reminders on oral hygiene compliance in orthodontic patients. Angle Orthod. 2014;84(2):208-213.
2. Al-Jewair TS, Suri S, Tompson BD. Predictors of adolescent compliance with oral hygiene instructions during two-arch multibracket fixed orthodontic treatment. Angle Orthod. 2011;81(3):525-531.
3. Cantekin K, Celikoglu M, Karadas M, et. al. Effects of orthodontic treatment with fixed appliances on oral health status: a comprehensive study. J Dent Sci. 2011;6(4):235-238.
4. Axelsson P. Current role of pharmaceuticals in prevention of caries and periodontal disease. Int Dent J. 1993;43(5):473-482.
5. Biesbrock AR, Bartizek RD, Walters PA. Improved plaque removal efficacy with a new manual toothbrush. J Contemp Dent Pract. 2008;9(4):1-8.
6. Aljabaa A, McDonald F, Newton JT. A systematic review of randomized controlled trials of interventions to improve adherence among orthodontic patients aged 12 to 18. Angle Orthod. 2015;85(2):305-313.
7. Richter DD, Nanda RS, Sinha PK, et. al. Effect of behavior modification on patient compliance in orthodontics. Angle Orthod. 1998;68(2):123-132.
8. Bartsch A, Witt E, Marks M. The influence of information and communication in the orthodontic consultation and treatment visit. II. The communication style and compliance. J Orofac Orthop. 1995;56(1):7-15.

9. Mehra T, Nanda R, Sinha P. Orthodontists' assessment and management of patient compliance. Angle Orthod. 1998;68(2):115-122.
10. Nanda RS, Kierl MJ. Prediction of cooperation in orthodontic treatment. Am J Orthod Dentofacial Orthop. 1992;102(1):15-21.
11. Sinha PK, Nanda RS. Improving patient compliance inorthodontic practice. Paper presented at: Seminars In Orthodontics2000.
12. Sinha PK, Nanda RS, McNeil DW. Perceived orthodontist behaviors that predict patient satisfaction, orthodontist-patient relationship, and patient adherence in orthodontic treatment. Am J Orthod Dentofacial Orthop. 1996;110(4):370-377.
13. Zachrisson BU. Oral hygiene for orthodontic patients: current concepts and practical advice. Am J Orthod. 1974;66(5):487-497.
14. Tuncer C, Canigur Bavbek N, Balos Tuncer B, et. al. How do patients and parents decide for orthodontic treatment–effects of malocclusion, personal expectations, education and media. J Clin Pediatr Dent. 2015;39(4):392-399.
15. Brattström V, Ingelsson M, Åberg E. Treatment co-operation in orthodontic patients. Br J Orthod. 1991;18(1):37-42.
16. Srai JPK, Petrie A, Ryan FS, et. al. Assessment of the effect of combined multimedia and verbal information vs verbal information alone on anxiety levels before bond-up in adolescent orthodontic patients: a single-center randomized controlled trial. Am J Orthod Dentofacial Orthop. 2013;144(4):505-511.
17. Thomson AM, Cunningham SJ, Hunt NP. A comparison of information retention at an initial orthodontic consultation. Eur J Orthod. 2001;23(2):169-178.
18. Clark GT. Teledentistry: what is it now, and what will it be tomorrow? J Calif Dent Assoc. 2000;28(2):121-126.
19. Jampani N, Nutalapati R, Dontula B, et. al. Applications of teledentistry: A literature review and update. J Int Soc Prev Community Dent. 2011;1(2):37-44.
20. Queyroux A, Saricassapian B, Herzog D, et al. Accuracy of teledentistry for diagnosing dental pathology using direct examination as a gold standard: results of the tel-e-dent study of older adults living in nursing homes. J Am Med Dir Assoc. 2017;18(6):528-532.
21. Özdede M, Bağcı N, Peker İ. COVID-19 pandemisi döneminde tele-diş hekimliği. Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi. 2020;27(3):482-489.
22. Marino R, Manton D, Hopcraft M, et al. Paediatric teledentistry: delivering oral health services to rural and regional children. 2014.
23. Wike R, Oates R. Emerging nations embrace internet, mobile technology: cell phones nearly ubiquitous in many countries. Washington DC: Pew Research Center. 2014.
24. Fijačko N, Gosak L, Cilar L, et al. The effects of gamification and oral self-care on oral hygiene in children: systematic search in app stores and evaluation of apps. JMIR mHealth and uHealth. 2020;8(7):e16365.
25. Toniazzo MP, Nodari D, Muniz FWMG, et. al. Effect of mHealth in improving oral hygiene: a systematic review with meta‐analysis. J Clin Periodontol. 2019;46(3):297-309.
26. Scheerman JF, van Meijel B, van Empelen P, et al. The effect of using a mobile application (“WhiteTeeth”) on improving oral hygiene: A randomized controlled trial. Int J Dent Hyg. 2020;18(1):73-83.
27. Greenstein G. The role of bleeding upon probing in the diagnosis of periodontal disease: a literature review. J Periodontol. 1984;55(12):684-688.
28. Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-551.
29. Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121-135.
30. Saxena K, Gunjal S. Influence of WhatsApp and electronic mail reminders on oral hygiene compliance of orthodontic patients using planimetry: A randomized clinical trial. J Orofac Orthop. 2022;83(4):269-276.
31. Ozsaygili M. Comparison of different orthodontic aligner systems applied on single stage and three stages in terms of comfort, satisfaction, treatment effects and duration. Kayseri/Turkey 2019.
32. Al-Ak’hali MS, Halboub ES, Asiri YM, et. al. WhatsApp-assisted oral health education and motivation: a preliminary randomized clinical trial. J Contemp Dent Pract. 2020;21(8):922-925.
33. Underwood B, Birdsall J, Kay E. The use of a mobile app to motivate evidence-based oral hygiene behaviour. Br Dent J. 2015;219(4):E2-E2.
34. Abdaljawwad AA. The influence of text message reminders on oral hygiene compliance in orthodontic patients. Iraqi Dent J. 2016;38(1):58-62.
35. Iqbal J, Awan R, Parvez MA, ul Haq A, et. al. Effectiveness of text message instructions on oral hygiene for orthodontic patients. Pak Oral Dent J. 2017;37(2):278-282.
36. Al-Silwadi FM, Gill DS, Petrie A, et. al. Effect of social media in improving knowledge among patients having fixed appliance orthodontic treatment: a single-center randomized controlled trial. Am J Orthod Dentofacial Orthop. 2015;148(2):231-237.
37. Charavet C, Le Gall M, Albert A, et. al. Patient compliance and orthodontic treatment efficacy of Planas functional appliances with TheraMon microsensors. Angle Orthod. 2019;89(1):117-122.
38. Chow J, Cioffi I. Pain and orthodontic patient compliance: a clinical perspective. Paper presented at: Seminars in orthodontics 2018.
39. Deleuse M, Meiffren C, Bruwier A, et. al. Smartphone application-assisted oral hygiene of orthodontic patients: a multicentre randomized controlled trial in adolescents. Eur J Orthod. 2020;42(6):605-611.
40. Papadimitriou A, Kakali L, Pazera P, et. al. Social media and orthodontic treatment from the patient’s perspective: a systematic review. Eur J Orthod. 2020;42(3):231-241.
41. Eddhaoui A, Aly TE, Haroon S. Digital Innovation in Oral Health Care: A Comprehensive Review. Open J Stomatol. 2025;15(1):1-24.
42. Hapsari D, Pamungkasari EP, Demartoto A. Effect of Mobile Application Use on Oral Hygiene among Orthodontics Users: Meta-Analysis. J Health Promot Behav. 2024;9(1):38-47.
43. Kim J, Choi Y, Song Y, et. al. Smartphone-Based Telemonitoring for Better Oral Health With Toothbrushes: 6-Month Randomized Controlled Trial. J Med Internet Res. 2025;27:e65128.
44. Lally P, Van Jaarsveld CH, Potts HW, et. al. How are habits formed: Modelling habit formation in the real world. Eur J Soc Psychol. 2010;40(6):998-1009.
45. Gupta G, Vaid N. The world of orthodontic apps. APOS Trends Orthod. 2017;7(2):73-73.

Details

Primary Language

English

Subjects

Orthodontics and Dentofacial Orthopaedics

Journal Section

Research Article

Authors

Hikmet Guliyev
0000-0003-0246-3343
Türkiye

Baris Baser ^*
0000-0002-3052-9023
Türkiye

Publication Date

June 30, 2025

Submission Date

October 23, 2024

Acceptance Date

March 22, 2025

Published in Issue

Year 2025 Volume: 28 Number: 2

IZ

https://izlik.org/JA32LA26TP

Cite

RIS / Bibtex

EndNote

Guliyev H, Baser B (June 1, 2025) Evaluation of the Effects of a Mobile Application on Oral Hygiene Motivation and Compliance with Fixed Orthodontic Patients. Cumhuriyet Dental Journal 28 2 132–140.