An orthodontic tooth brushing technique to enhance oral hygiene in patients with fixed appliances: interim results of a randomized controlled clinical trial

Abstract

Introduction: Traditional tooth brushing techniques, such as the Modified Bass technique, are designed and aimed at the general population without orthodontic appliances. An effective tooth brushing technique for patients wearing orthodontic fixed appliances is still lacking. In this study, an Orthodontic tooth brushing technique was designed to enhance the oral hygiene of patients with fixed orthodontic appliances, and compared its efficacy with that of the traditional Modified Bass technique. Method: This study was conducted as a single blind randomised controlled clinical trial with two parallel arms. With an aim to recruit 60 patients, this interim analysis included 34. To date, 18 patients were assigned to the Modified Bass technique, and 16 patients were assigned to the Orthodontic technique. Plaque index (PI) was assessed on four surfaces of the teeth in relation to the bracket: PIG, gingival; PIM, mesial; PID, distal; and PIO, occlusal. Gingival index (GI) was assessed in three areas: GIMid, mid-labial; GIM, mesial; and GID, distal. Outcome measurements were taken at baseline (T0) and one-month (T1) after the intervention. Results: After one-month follow up, the Orthodontic group had a significant reduction in their overall PI (0.37 ± 0.10, p < 0.05). This was mainly due to the reduction of PIG (0.54 ± 0.16, p < 0.05), and PIM+D (0.43 ± 0.12, p < 0.05). There was no significant reduction of the GI overall (0.08 ± 0.07, p > 0.05). The Modified Bass group had no significant reduction of PI and GI on all surfaces (p > 0.05). When comparing the two groups, the reduction of PIG of the Orthodontic group was significantly higher (p = 0.041) than the Modified Bass group. No significant differences in the reduction of PI and GI were observed on all other surfaces (p ≥ 0.086). Conclusion: Within the limitations of the present interim analysis, the Orthodontic tooth brushing technique shows promising results in improving oral hygiene in patients with fixed appliances. However, our preliminary findings indicate that further research is required to verify the efficacy of the Orthodontic technique observed in this interim analysis. Also, the Modified Bass technique may not be effective in improving the oral hygiene of orthodontic patients.