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Advisory Committee Chair

Chung How Kau

Advisory Committee Members

Maninder Kaur

Javed Amjad

Document Type

Thesis

Date of Award

2017

Degree Name by School

Master of Dentistry (MDent) School of Dentistry

Abstract

Introduction: One of the most challenging tasks of the orthodontic team is to motivate patients to maintain proper oral hygiene. In order to improve compliance, clinicians are utilizing mobile applications. The goals of this study are to determine the efficacy of an application-based approach in increasing orthodontic patient’s oral hygiene compliance, as well as measure the correlation between the reported compliance and clinical parameters of gingival health. Materials & Methods: The Beam® toothbrush and its application software (app) were selected for evaluation. Three prospective groups of 15 patients undergoing routine orthodontic treatment were evaluated as part of this research protocol (total recruitment of 45 patients) and were followed up during the early stages of orthodontic treatment. The study parameters included: oral health evaluation, application tracking, and reported compliance. Patients were recalled 3 times for a complete clinical evaluation Results: Group 2 was the only group to show a statistically significant (p < 0.017) difference of plaque and gingival scores across time points. There was no significant difference in plaque and gingival scores over time across all groups. Group 2 sextants 1 & 3 showed greater increases in plaque and gingival scores. Comparing patient questionnaire responses to data collected from the Beam application software, no effective agreement was found in brushing frequency. Q2 vs Q2 app data showed a iv perfect agreement with Kappa of 1. Q3 vs Q3 app data also showed a 100% raw agreement, but with a Kappa of 0.5. Conclusions: Proper oral hygiene instructions seem to be the most important variable in achieving plaque control, as well as patient motivation and diet control. It is important for clinicians to continuously provide oral hygiene instructions throughout the course of orthodontic care. Overall brushing quality depends on brushing technique and does not seem to be device related. Frequency and duration of brushing are not as important as brushing quality. Patients that use toothbrushes with built-in timers may be more likely to brush the required time frame (2 min). The use of toothbrushes associated with apps could be promising to increase compliance within an orthodontic practice as long as a reliable app/device system can be built.

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