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Yasuda J, Yasuda H, Nomura R, Matayoshi S, Inaba H, Gongora E, Iwashita N, Shirahata S, Kaji N, Akitomo T, Mitsuhata C, Uchiyama J, Fukuyama T, Matsumoto-Nakano M, Nakano K, Murakami M. Investigation of periodontal disease development and Porphyromonas gulae FimA genotype distribution in small dogs. Sci Rep 2024; 14:5360. [PMID: 38438471 PMCID: PMC10912432 DOI: 10.1038/s41598-024-55842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/28/2024] [Indexed: 03/06/2024] Open
Abstract
In dogs, Porphyromonas gulae is a major periodontal pathogen with 41-kDa proteins polymerizing to form a filamentous structure called fimbriae or pili, termed FimA. FimA is classified into three genotypes: A, B, and C, and there are combinations of types A, B, C, A/B, A/C, B/C, and A/B/C. Periodontal disease is the most common oral disease in small dogs, but the periodontal disease status and P. gulae colonization at each dog age and breed remain unclear. In this study, we stratified 665 small dogs and analyzed the periodontal status and distribution of P. gulae with each FimA genotype. Dogs with periodontal disease and FimA genotype tended to increase with age. The dogs with at least one FimA genotype had significantly more severe periodontal disease compared with P. gulae-negative dogs (P < 0.01). Additionally, periodontal status was significantly associated with specific FimA genotype distribution in Toy Poodles and Chihuahuas (P < 0.05), whereas there was no such association in Dachshunds. These results suggest that the onset of periodontal disease and P. gulae colonization are related and progress with age. The relationship between periodontal disease and FimA genotype may differ depending on the dog breeds.
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Affiliation(s)
- Junya Yasuda
- Department of Molecular Biology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Yasuda Veterinary Clinic, Meguro, Tokyo, Japan
| | | | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hiroaki Inaba
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Naoki Iwashita
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Bioalch, Fuchu, Tokyo, Japan
| | - So Shirahata
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
- Primo Animal Hospital, Sagamihara, Kanagawa, Japan
| | - Noriyuki Kaji
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Tatsuya Akitomo
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Chieko Mitsuhata
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Jumpei Uchiyama
- Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoki Fukuyama
- Department of Pharmacology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Michiyo Matsumoto-Nakano
- Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masaru Murakami
- Department of Molecular Biology, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
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Rogers AA, Willumsen T, Strømme H, Johnsen JAK. Top-down self-regulation processes as determinants of oral hygiene self-care behaviour: A systematic scoping review. Clin Exp Dent Res 2022; 8:807-826. [PMID: 35396799 PMCID: PMC9382055 DOI: 10.1002/cre2.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 02/03/2022] [Accepted: 02/11/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives Understanding the psychological mechanisms that moderate oral hygiene self‐care behavior is anticipated to benefit efforts to change such behavior. Top‐down self‐regulatory (TSR) processes represent one group of relatively unexplored, yet potentially influential, moderating factors. This systematic scoping review aims to explore whether there is evidence that TSR processes moderate oral hygiene self‐care engagement within the current literature. Methods CINAHL, The Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus, and Web of Science databases were searched up to April 2020 for articles that compared measures of TSR processes (such as self‐monitoring, inhibitory control, and task switching) to oral hygiene self‐care behavior, or tested interventions that aimed to change or support TSR processes. Results The search returned 6626 articles, with 25 included in the final sample. Weak evidence supported both the role of TSR processes as moderators of interdental cleaning and the value of interventions targeting self‐monitoring of interdental cleaning behavior. Overall, methodological limitations rendered the findings somewhat inconclusive, with an absence of objective assessments of TSR capacity, and little focus on TSR processes as moderators of intervention effects. Conclusions The inconclusive, but reasonably promising, findings point to the value of continuing to apply TSR processes within studies of oral hygiene behavior. Exploring why interdental cleaning appears more reliant on TSR processes than toothbrushing, employing objective neuropsychological assessment, and measuring TSR constructs within interventions targeting TSR processes, are encouraged. As a scoping review, the study hopes to generate interest and serve as a starting point for further investigation.
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Affiliation(s)
- Adam A Rogers
- Institute of Clinical Dentisty, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Institute of Clinical Dentisty, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Strømme
- University of Oslo Library, University of Oslo, Oslo, Norway
| | - Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
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Hollands GJ, Usher-Smith JA, Hasan R, Alexander F, Clarke N, Griffin SJ. Visualising health risks with medical imaging for changing recipients' health behaviours and risk factors: Systematic review with meta-analysis. PLoS Med 2022; 19:e1003920. [PMID: 35239659 PMCID: PMC8893626 DOI: 10.1371/journal.pmed.1003920] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 01/19/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is ongoing clinical and research interest in determining whether providing personalised risk information could motivate risk-reducing health behaviours. We aimed to assess the impact on behaviours and risk factors of feeding back to individuals' images of their bodies generated via medical imaging technologies in assessing their current disease status or risk. METHODS AND FINDINGS A systematic review with meta-analysis was conducted using Cochrane methods. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to July 28, 2021, with backward and forward citation searches up to July 29, 2021. Eligible studies were randomised controlled trials including adults who underwent medical imaging procedures assessing current health status or risk of disease, for which personal risk may be reduced by modifying behaviour. Trials included an intervention group that received the imaging procedure plus feedback of visualised results and assessed subsequent risk-reducing health behaviour. We examined 12,620 abstracts and included 21 studies, involving 9,248 randomised participants. Studies reported on 10 risk-reducing behaviours, with most data for smoking (8 studies; n = 4,308), medication use (6 studies; n = 4,539), and physical activity (4 studies; n = 1,877). Meta-analysis revealed beneficial effects of feedback of visualised medical imaging results on reduced smoking (risk ratio 1.11, 95% confidence interval [CI] 1.01 to 1.23, p = 0.04), healthier diet (standardised mean difference [SMD] 0.30, 95% CI 0.11 to 0.50, p = 0.003), increased physical activity (SMD 0.11, 95% CI 0.003 to 0.21, p = 0.04), and increased oral hygiene behaviours (SMD 0.35, 95% CI 0.13 to 0.57, p = 0.002). In addition, single studies reported increased skin self-examination and increased foot care. For other behavioural outcomes (medication use, sun protection, tanning booth use, and blood glucose testing) estimates favoured the intervention but were not statistically significant. Regarding secondary risk factor outcomes, there was clear evidence for reduced systolic blood pressure, waist circumference, and improved oral health, and some indication of reduced Framingham risk score. There was no evidence of any adverse effects, including anxiety, depression, or stress, although these were rarely assessed. A key limitation is that there were some concerns about risk of bias for all studies, with evidence for most outcomes being of low certainty. In particular, valid and precise measures of behaviour were rarely used, and there were few instances of preregistered protocols and analysis plans, increasing the likelihood of selective outcome reporting. CONCLUSIONS In this study, we observed that feedback of medical images to individuals has the potential to motivate risk-reducing behaviours and reduce risk factors. Should this promise be corroborated through further adequately powered trials that better mitigate against risk of bias, such interventions could usefully capitalise upon the widespread and growing use of medical imaging technologies in healthcare.
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Affiliation(s)
- Gareth J. Hollands
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- EPPI-Centre, UCL Social Research Institute, University College London, London, United Kingdom
- * E-mail:
| | - Juliet A. Usher-Smith
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Rana Hasan
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Florence Alexander
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Natasha Clarke
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Simon J. Griffin
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- MRC Epidemiology Unit, Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Seirawan H, Parungao K, Habibian M, Slusky N, Edwards C, Artavia M, Cen S, Chan C, Mulligan R. The Children's Health and Maintenance Program (CHAMP): An innovative community outreach oral health promotion program: A randomized trial. Community Dent Oral Epidemiol 2020; 49:192-200. [PMID: 33135179 DOI: 10.1111/cdoe.12591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/04/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe CHAMP (Children's Oral Health Promotion Program) evaluating the impact of two motivational methods in increasing dental care access. METHODS CHAMP is a multi-dimensional oral health promotion programme that recruited and screened underprivileged children/families from community sites in Los Angeles County between 2012 and 2018. A randomized clinical trial (RCT) enrolled children/families into one or more motivational interventions (intra-oral camera and/or social work consultation) designed to impact subsequent scheduling of dental appointments. RESULTS CHAMP served 24 535 families. RCT had 418 families with 68.5% scheduling appointments by second follow-up (P < .001). Excluding children with scheduled appointments by first follow-up, children experiencing both interventions were 4.1 (95% CI 1.5-11.2) times more likely to schedule appointments by second follow-up than were the controls (P=<.01). When experiencing both interventions and had never previously been to the dentist, 68.3% scheduled dental appointments; this was significantly higher than the controls (46.7%) (P = .04). The best predictor for families to have scheduled appointments was a dental visit within the last six months [OR = 3.8 (95% CI 2.2-6.6), P < .001]. CONCLUSIONS Outreach health promotion programmes are important and should consider utilizing various motivational techniques to encourage enrolment and treatment at dental homes.
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Affiliation(s)
- Hazem Seirawan
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
| | - Kristine Parungao
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
| | - Mina Habibian
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
| | - Natalia Slusky
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
| | - Christine Edwards
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
| | - Margarita Artavia
- USC Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Steven Cen
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chan Chan
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
| | - Roseann Mulligan
- Herman Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, CA, USA
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Nayak N, Varghese J, Shetty S, Bhat V, Durgekar T, Lobo R, Nayak UY, U V. Evaluation of a mouthrinse containing guava leaf extract as part of comprehensive oral care regimen- a randomized placebo-controlled clinical trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:327. [PMID: 31752836 PMCID: PMC6873761 DOI: 10.1186/s12906-019-2745-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/04/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND The control of biofilm adherence on tooth surface has always been the keystone of periodontal therapeutic systems. However, prevalence of gingivitis suggest inadequacy of self-performed oral hygiene measures and need for adjunctive aid for mechanical plaque control. Oral rinses containing chlorhexidine, has been widely used however, with certain limitations. Herbal products have been used widely reflecting its action as alternative and complementary remedy. Hence, the purpose of the present study was to evaluate the antimicrobial and antioxidant efficacy of a Guava leaf extract based mouthrinse in patients with chronic generalized gingivitis as an adjunct to oral prophylaxis. METHODS Sixty subjects (n = 20) in compliance with the inclusion criteria were randomly assigned to one of the 3 study groups i.e. Group A- 0.15%Guava mouth rinse, Group B- 0.2% Chlorhexidine (CHX) mouth rinse, Group C- Distilled water (placebo). All the participants received professional oral prophylaxis and were dispensed with experimental mouth rinses and instructed to use for period of 30 days. Clinical parameters such as gingival index, plaque index along with microbial colony forming units using plaque samples and antioxidant levels in saliva were estimated at baseline, 30 and 90 days' time intervals. RESULTS All 3 groups showed gradual reduction in GI, PI and microbial counts. Considering the mean scores of recorded parameters at the scheduled time intervals, notable changes were observed between chlorhexidine and guava mouth rinse compared to placebo group. Although there was improvement in the antioxidant status in all study participants, yet there was no statistically significant difference observed. CONCLUSION Guava mouth rinse can be used as an empirical adjunct to professional oral prophylaxis owing to its multifactorial properties and favourable acceptance. However, long term studies need to be conducted to validate its use for an extended period of time. TRIAL REGISTRATION The clinical trial has been prospectively registered on 17th February 2017 by the Clinical Trials Registry-India (CTRI/2017/02/007898).
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6
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Pentapati KC, Siddiq H. Clinical applications of intraoral camera to increase patient compliance - current perspectives. Clin Cosmet Investig Dent 2019; 11:267-278. [PMID: 31692486 PMCID: PMC6712211 DOI: 10.2147/ccide.s192847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/26/2019] [Indexed: 01/20/2023] Open
Abstract
Technological advancements in the field of dentistry have reformed the concept of photography as a powerful medium of expression and communication. It also offers a spectrum of perception, interpretation, and execution. One of the widespread clinical applications of computerization in dentistry today is the intraoral camera (IOC). It helps in the revelation of the hidden and overlooked defects in teeth and other parts of the cavity. Dental world constitutes of microstructures that have to be recorded in a detailed manner to perform patient education, documentation of records and treatment, illustration of lectures, publication and web connectivity of complicated cases. This review emphasizes the significant applications of IOC in dentistry and its possible impact on patient compliance for dental care.
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Affiliation(s)
- Kalyana-Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Hanan Siddiq
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Murrell M, Marchini L, Blanchette D, Ashida S. Intraoral Camera Use in a Dental School Clinic: Evaluations by Faculty, Students, and Patients. J Dent Educ 2019; 83:1339-1344. [PMID: 31406005 DOI: 10.21815/jde.019.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/17/2019] [Indexed: 11/20/2022]
Abstract
The aims of this study were to assess the perceptions of dental students, faculty members, and patients about the benefits and pitfalls of intraoral camera use and to compare the completion rate of treatment planned posterior crowns with and without intraoral camera use in a predoctoral dental clinic. From July 2016 to June 2017, all 60 fourth-year dental students at one U.S. dental school were encouraged to use the intraoral camera in treatment planning with patients in the school clinic. Perceptions of the students, their patients, and the faculty members supervising the treatment planning were assessed with a survey at the end of the treatment planning appointment. The completion rate of treatment planned posterior crowns was determined by recalling all posterior teeth that were treatment planned for a single unit crown at a specific period of time compared to the number of the same crowns completed for the same patients at a specific period of time, using the electronic health record, with and without camera use. Of the 60 students, 51 completed 198 surveys (85% response rate); 35 faculty members completed 64 surveys, and 202 patients completed one survey each (response rates for those groups could not be calculated). The survey results suggested that the students, faculty, and patients viewed intraoral camera use in a positive way. However, faculty perceptions were a little lower than those of patients and students, and a significant number of faculty members were neutral. The completion rate of posterior planned crowns was significantly higher (p=0.0005) when intraoral cameras were used to present images to patients than when cameras were not used. In this study, intraoral camera use in a predoctoral clinic was perceived positively by students and patients but more neutrally by faculty, and it increased the completion rate of planned posterior crowns.
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Affiliation(s)
- Michael Murrell
- Michael Murrell is Clinical Assistant Professor, University of Iowa College of Dentistry & Dental Clinics; Leonardo Marchini is Associate Professor, University of Iowa College of Dentistry & Dental Clinics; Derek Blanchette is Biostatistician, University of Iowa; and Sato Ashida is Associate Professor, College of Public Health, University of Iowa
| | - Leonardo Marchini
- Michael Murrell is Clinical Assistant Professor, University of Iowa College of Dentistry & Dental Clinics; Leonardo Marchini is Associate Professor, University of Iowa College of Dentistry & Dental Clinics; Derek Blanchette is Biostatistician, University of Iowa; and Sato Ashida is Associate Professor, College of Public Health, University of Iowa.
| | - Derek Blanchette
- Michael Murrell is Clinical Assistant Professor, University of Iowa College of Dentistry & Dental Clinics; Leonardo Marchini is Associate Professor, University of Iowa College of Dentistry & Dental Clinics; Derek Blanchette is Biostatistician, University of Iowa; and Sato Ashida is Associate Professor, College of Public Health, University of Iowa
| | - Sato Ashida
- Michael Murrell is Clinical Assistant Professor, University of Iowa College of Dentistry & Dental Clinics; Leonardo Marchini is Associate Professor, University of Iowa College of Dentistry & Dental Clinics; Derek Blanchette is Biostatistician, University of Iowa; and Sato Ashida is Associate Professor, College of Public Health, University of Iowa
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Scheerman JFM, van Meijel B, van Empelen P, Verrips GHW, van Loveren C, Twisk JWR, Pakpour AH, van den Braak MCT, Kramer GJC. The effect of using a mobile application ("WhiteTeeth") on improving oral hygiene: A randomized controlled trial. Int J Dent Hyg 2019; 18:73-83. [PMID: 31291683 PMCID: PMC7004072 DOI: 10.1111/idh.12415] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/20/2019] [Accepted: 07/04/2019] [Indexed: 12/02/2022]
Abstract
Objective To evaluate the effectiveness of the WhiteTeeth mobile app, a theory‐based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients. Methods In this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check‐ups: at baseline (T0), at 6‐week follow‐up (T1) and at 12‐week follow‐up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n = 67). The control group received usual care only (n = 65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al‐Anezi and Harradine plaque index), and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behaviour and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed‐model analyses to determine the intervention effects. Results At 6‐week follow‐up, the intervention led to a significant decrease in gingival bleeding (B = −3.74; 95% CI −6.84 to −0.65) and an increase in the use of fluoride mouth rinse (B = 1.93; 95% CI 0.36 to 3.50). At 12‐week follow‐up, dental plaque accumulation (B = −11.32; 95% CI −20.57 to −2.07) and the number of sites covered with plaque (B = −6.77; 95% CI −11.67 to −1.87) had been reduced significantly more in the intervention group than in the control group. Conclusions The results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.
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Affiliation(s)
- Janneke F M Scheerman
- Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.,TNO Research Group, Leiden, The Netherlands
| | - Berno van Meijel
- Inholland University of Applied Sciences, Amsterdam, The Netherlands.,VU Medical Center Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute (EMGO), Amsterdam, The Netherlands
| | | | | | - Cor van Loveren
- Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Jos W R Twisk
- VU Medical Center Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute (EMGO), Amsterdam, The Netherlands
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.,Jönköping University, Jönköping, Sweden
| | | | - Gem J C Kramer
- Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
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