Smartphone App Versus Verbal Motivation for Oral Hygiene in Fixed Orthodontic Patients

Overview

This study looked at whether a smartphone app can help patients with fixed braces keep their teeth cleaner than usual spoken advice alone. Fixed braces make plaque harder to remove, which can harm the teeth and gums, so good brushing habits matter. Fifty patients aged 14 to 22 were divided at random into two groups. One group used a purpose-made app ("iTeeth Orthodontics") that sent brushing reminders, timed brushing, and kept a brushing log. The other group received the usual spoken oral-hygiene motivation. Both groups used the same brushes, toothpaste, and rinse, and followed the same cleaning routine. Plaque was measured from photographs at 10 days and at 1, 2, and 3 months, using a computer to calculate how much of each tooth surface was covered by plaque. The two groups were then compared.

ackground and objective: Maintaining oral hygiene during fixed orthodontic treatment is difficult, and patient motivation is central to preventing plaque accumulation, enamel demineralization, and gingival inflammation. This trial compared a purpose-built smartphone application with conventional verbal motivation for plaque control during fixed orthodontic treatment. Design: Prospective, randomized, controlled, parallel-group (1:1) in vivo trial conducted at the Department of Orthodontics, Faculty of Dentistry, Ondokuz Mayıs University (Samsun, Türkiye). Fifty patients (14-22 years) with Class I or II malocclusion who owned and used a smartphone were enrolled and allocated equally to a mobile group (app plus standard regimen) or a control group (verbal motivation plus the identical regimen). Intervention: The "iTeeth Orthodontics" application provided treatment information, customizable brushing reminders (push notifications), an adjustable brushing timer with interdental-brush and mouthrinse prompts, and a daily/weekly/monthly brushing log. Both groups used identical brackets, archwires, toothbrushes, interdental brushes, toothpaste, and mouthrinse, and followed the same oral-hygiene regimen (modified Bass brushing three times daily, nightly interdental cleaning, and mouthrinse), so that the motivational method was the only variable. Outcome and assessment: Plaque was recorded at day 10 (T0) and at 1 (T1), 2 (T2), and 3 (T3) months. After application of a disclosing agent, standardized intraoral photographs were taken, and the disclosed plaque area on the maxillary central incisors, canines, and second premolars was quantified by computer-assisted planimetry as a percentage of the total visible buccal crown surface. The outcome assessor was blinded to group and time point. Between-group and over-time comparisons were then performed.