Examining the impact of instruction on oral care knowledge and habits among adults wearing fixed braces

Abstract

Introduction: Special care is needed when wearing fixed orthodontic appliances, as they create more surfaces in the
oral cavity, which can make oral care more difficult and can lead to gingivitis or periodontitis. It is therefore essential to
provide full information on oral care habits and knowledge, which is the responsibility of the dental hygienist. The aim of
this six-week longitudinal study was to assess the impact of oral hygiene instructions provided in different ways during
the period of fixed orthodontic appliance fitting in an adult population.
Study material and method: The study of the effect of the oral hygiene instructions was conducted in two groups (verbal
and video-based instruction), patients arriving to private practice were grouped in the order of arrival, no two consecutive
patients were grouped in the same group. During the first data collection session, a self-report based test battery
was used to assess oral hygiene tool knowledge and habits. At the first data collection appointment, the test battery
was completed, followed by the fitting of the fixed orthodontic appliance and instructions according to the group classification,
and after six weeks during the first activation the second data collection took place with the test battery being
completed again.
Results: A total of 47 participants were included in the longitudinal study. Both study groups showed improvements
in oral hygiene tool knowledge and positive changes in oral care habits, however the changes were more intense in both
tool knowledge (p = 0.003) and oral care habits (p = 0.007) with video-based instruction compared to the only oral instruction
group. This result was confirmed by the fact that 91% of the group receiving the video-based instruction took
the opportunity to watch the video at least once more after the first instruction, and that this group rated the instruction
as significantly more effective than the group receiving oral instruction (p < 0.001).
Discussion: The study highlighted the importance of accurate and easy-to-follow instructions when fitting fixed appliances,
and the usefulness of having the information provided available for later review. Feedback from the study population
also showed that such information is beneficial for adherence and compliance.