Oral Hygiene of Patients Receiving Orthodontic Treatment With Fixed Appliances May Be Enhanced by Showing Them Images of Severe Consequences of Poor Oral Hygiene

Subjects A total of 148 individuals were randomized, with follow-up data available for 130 individuals (77 females, 59.2%). All participants were aged between 11 and 25 years, were wearing fixed orthodontic appliances, and lived in Chengdu, China. Follow-up data were collected monthly for 6 months. Key Exposure/Study Factor The primary exposure was exposing the participants to images showing the severe consequences of failure to maintain a good standard of oral hygiene during orthodontic treatment. Four intervention groups were used: group A participants (n = 35) were exposed to images showing the severe consequences of failure to maintain good oral hygiene during orthodontic treatment, group B (n = 32) received a plaque disclosure intervention, group C (n = 38) were exposed to images showing the severe consequences of failure to maintain good oral hygiene during orthodontic treatment as well as a plaque disclosure intervention, and group D (n = 29) received only routine oral hygiene instructions and served as the control group. All participants received verbal instructions on tooth brushing techniques, basic information about the plaque biofilm, and dietary suggestions. Main Outcome Measure The primary outcome measure was improvement in the plaque and gingival indices. The examiner for the follow-up examinations was blinded to the participants' intervention allocation group. Main Results Compared with the control group, Group A (those who received the visual intervention) exhibited significantly lower scores for the plaque and gingival indices (parameter estimates -1.20 and -0.13, respectively). Group C (those who received the visual intervention and plaque disclosing) also exhibited significantly lower scores than the control group for the plaque and gingival indices (parameter estimates -1.12 and -0.19, respectively). Those who received the plaque disclosing alone did not experience significantly lower plaque and gingival index scores than the control group. Conclusions These data suggest that the intervention has some effect in improving oral hygiene among patients treated with fixed orthodontic appliances.