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Abstract

The purpose of this study was to compare 3 methods designed to enhance adherence to oral hygiene instructions in orthodontic patients: mind map, if-then plan, and leaflet. The study was a 3-arm parallel trial involving 90 orthodontic patients. The 3 groups were mind mapping, if-then planning, and patient information tools (leaflet). Group allocation was randomized in a 1:1:1 ratio. Allocation was concealed using sealed envelopes. The participant and their parents as well as the researcher undertaking the intervention and assessing the outcomes were not blinded. The statistician undertaking the analysis was blinded. Primary outcomes were plaque levels and bleeding point index. Secondary outcomes were patients’ knowledge of behaviors deemed important during orthodontic treatment and self-reported behavior. Participants were assessed at 4 time points: at the fitting of the fixed appliance (T1), at initial follow-up 6 wk later (T2, at which time they were randomly allocated to the 3 groups of intervention), 6 wk after the intervention (T3), and 18 wk postintervention (T4). Mean levels of buccal and lingual plaque, as well as the proportion of sites with bleeding sites, showed no significant differences over time (buccal plaque, F_time = 3.74, P = 0.06; lingual plaque, F_time = 2.78, P = 0.06; bleeding on probing, F_time = 0.68, P = 0.51) or between interventions over time (buccal plaque, F_int × F_time = 0.38, P = 0.68; lingual plaque, F_int × F_time = 0.30, P = 0.88; bleeding on probing, F_int × F_time = 0.70, P = 0.59). There were no harmful consequences detected for any of the interventions. No single method of presenting the information proved superior to any other. This trial was registered with the Guy’s & St Thomas’s NHS Trust Research & Development Database.

Knowledge Transfer Statement: Enhancing patient adherence to advice given by their clinician is an important component of orthodontic treatment. This study explored the use of structured techniques to enhance adherence. All 3 techniques enhanced adherence over the 18-wk study period when orthodontic treatment was being provided, but no single method proved superior to any other.

Keywords

compliance oral hygiene behavior behavioral science concordance fixed appliance

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References

Abraham

Kelly

West

Michie

2009. The UK National Institute for Health and Clinical Excellence public health guidance on behaviour change: a brief introduction. Psychol Health Med. 14(1):1–8.

Acharya

Goyal

Utreja

Mohanty

2011. Effect of three different motivational techniques on oral hygiene and gingival health of patients undergoing multibracketed orthodontics. Angle Orthod. 8(5):884–888.

Aljabaa

McDonald

Newton

. 2015. A systematic review of randomized controlled trials of interventions to improve adherence among orthodontic patients aged 12 to 18. Angle Orthod. 85(2):305–313.

Aloufi

Giancio

Shibley

2010. Plaque accumulation in adolescent orthodontic patients: bonded versus banded teeth. Dent Learning. [accessed 2015 Dec 23];4(6):1–3. http://www.dentallearning.net/articles/plaque-accumulation-adolescent-orthodontic-patients-bonded-versus-banded-teeth.

Asimakopoulou

Daly

2009. Adherence in dental settings. Dent Update. 36(10):626–630.

Asimakopoulou

Newton

. 2015. The contributions of behaviour change science towards dental public health practice: a new paradigm. Community Dent Oral Epidemiol. 43(1):2–8.

Beane

Reimann

Phillips

Tulloch

2003. A cephalometric comparison of black open-bite subjects and black normals. Angle Orthod. 73(3):294–300.

Brook

Shaw

. 1989. The development of an index of orthodontic treatment priority. Eur J Orthod. 11(3):309–320.

Faul

Erdfelder

Lang

Buchner

2007. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 39(2):175–191.

10.

Feil

Grauer

Gadbury-Amyot

Kula

McCunniff

. 2002. Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients. J Dent Educ. 66(10):1129–1135.

11.

Gwinnett

Ceen

. 1979. Plaque distribution on bonded brackets: a scanning microscope study. Am J Orthod. 75(6):667–677.

12.

Hamdan

Rock

. 2001. Cephalometric norms in an Arabic population. J Orthod. 28(4):297–300.

13.

Health Social Care Information Centre. Adult Dental Health Survey 2009—summary report and thematic series [accessed 2015 Sept 28]. http://www.hscic.gov.uk/pubs/dentalsurveyfullreport09.

14.

Howe

McNamara

O’Connor

. 1983. An examination of dental crowding and its relationship to tooth size and arch dimension. Am J Orthod. 83(5):363–373.

15.

Lavelle

CLB

. 1973. Variation in the secular changes in the teeth and dental arches. Angle Orthod. 43(4):412–421.

16.

Mehra

Nanda

Sinha

. 1998. Orthodontists’ assessment and management of patient compliance. Angle Orthod. 68(2):115–122.

17.

Miyajima

McNamara

Kimura

Murata

Iizuka

. 1996. Craniofacial structure of Japanese and European-American adults with normal occlusions and well-balanced faces. Am J Orthod Dentofacial Orthop. 110(4):431–438.

18.

O’Leary

Drake

Naylor

. 1972. The plaque control record. J Periodontol. 43(1):38.

19.

Parsons

. 1991. Hawthorne: an early OBM experiment. J Organ Behav Manage. 12(1):27–43.

20.

Proffit

Fields

Sarver

. 2012. Contemporary orthodontics. 5th ed. St Louis (MO): Elsevier.

21.

Richter

Nanda

Sinha

Smith

Currier

. 1998. Effect of behavior modification on patient compliance in orthodontics. Angle Orthod. 68(2):123–132.

22.

Schüz

Sniehotta

Wiedemann

Seemann

2006. Adherence to a daily flossing regimen in university students: effects of planning when, where, how and what to do in the face of barriers. J Clin Periodontol. 33(9):612–619.

23.

Sniehotta

Soares

Dombrowski

. 2007. Randomized controlled trial of a one-minute intervention changing oral self-care behavior. J Dent Res. 86:641–645.

24.

Steiner

. 1953. Cephalometrics for you and me. Am J Orthod. 39(7):729–755.

25.

Suresh

Jones

Newton

Asimakopoulou

2012. An exploratory study into whether self-monitoring improves adherence to daily flossing among dental patients. J Public Health Dent. 72(1):1–7.

26.

Thickett

Newton

. 2006. Using written material to support recall of orthodontic information: a comparison of three methods. Angle Orthod. 76(2):243–250.

27.

Thomson

Cunningham

Hunt

. 2001. A comparison of information retention at an initial orthodontic consultation. Eur J Orthod. 23(2):169–178.

28.

Veeroo

Cunningham

Newton

Travess

. 2014. Motivation and compliance with intraoral elastics. Am J Orthod Dentofacial Orthop. 146(1): 33–39.

29.

Wright

Fleming

Sharma

Battagel

2010. Influence of supplemental written information on adolescent anxiety, motivation and compliance in early orthodontic treatment. Angle Orthod. 80(2):329–335.

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A Randomized Controlled Trial to Compare 3 Methods Designed to Enhance Adherence among Orthodontic Patients

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