The Effect of Chairside Verbal Instructions Matched with Instagram Social Media on Oral Hygiene of Young Orthodontic Patients: A Randomized Clinical Trial

The Use of Social Media on Enhancing Dental Care and Practice Among Dental Professionals: Cross-Sectional Survey Study

Background

As digitalization continues to advance globally, the health care sector, including dental practice, increasingly recognizes social media as a vital tool for health care promotion, patient recruitment, marketing, and communication strategies.

Objective

This study aimed to investigate the use of social media and assess its impact on enhancing dental care and practice among dental professionals in the Philippines.

Methods

A cross-sectional survey was conducted among dental practitioners in the Philippines. The study used a 23-item questionnaire, which included 5 questions on dentists' background and demographic information and 18 questions regarding the use, frequency, and purpose of social media in patient advising and quality of care improvement. Data were analyzed using SPSS software, with frequency distributions and χ2 tests used to assess the association between social media use and demographic variables and the impact on dental practice.

Results

The 265 dental practitioners in this study were predominantly female (n=204, 77%) and aged between 20-30 years (n=145, 54.7%). Most of the participants were general practitioners (n=260, 98.1%) working in a private practice (n=240, 90.6%), with 58.5% (n=155) having 0-5 years of clinical experience. Social media use was significantly higher among younger practitioners (20-30 years old) compared to older age groups (P<.001), though factors such as sex, dental specialty, and years of clinical practice did not significantly influence use. The majority (n=179, 67.5%) reported using social media in their practice, primarily for oral health promotion and education (n=191, 72.1%), connecting with patients and colleagues (n=165, 62.3%), and marketing (n=150, 56.6%). Facebook (n=179, 67.5%) and YouTube (n=163, 61.5%) were the most frequented platforms for clinical information, with Twitter (subsequently rebranded X) being the least used (n=4, 1.5%). Despite widespread social media engagement, only 8.7% (n=23) trusted the credibility of web-based information, and 63.4% (n=168) perceived a potential impact on the patient-dentist relationship due to patients seeking information on the internet. Social media was also perceived to enhance practice quality, with users reporting significant improvements in patient care (P=.001).

Conclusions

The findings highlight that social media is widely used among younger dental practitioners, primarily for education, communication, and marketing purposes. While social media use is associated with perceived improvements in practice quality and patient care, trust in information on social media remains low, and concerns remain regarding its effect on patient relationships. It is recommended to establish enhanced guidelines and provide reliable web-based resources to help dental practitioners use social media effectively and responsibly.

A short-term evaluation of oral hygiene education methods in fixed orthodontics patients: a randomized clinical trial comparing assistant training, software, and social media

OBJECTIVE

To compare the effectiveness of different oral hygiene education strategies on periodontal health in fixed orthodontic patients in a one-month period: assistant-led instruction, social media-based education, and custom-made software.

METHODS

Sixty orthodontic patients from Mashhad University of Medical Sciences' Dentistry School were randomly assigned into three groups. Each group received oral health education differently: via assistant instruction, educational videos on social media, or a researcher-designed software for Android smartphones. After a month, participants' oral health was evaluated using the plaque index (PI) and the gingival index (GI).

RESULTS

Assistant-led education group demonstrated the highest PI (1.26 ± 0.70) and GI (0.92 ± 0.67), while the software group reported the lowest indices (PI = 0.68, GI = 0.46 ± 0.46). The social media group's measurements fell between these extremes (PI = 0.89 ± 0.75, GI = 0.60 ± 0.52). Significant group differences were found for both PI and GI (P = 0.028 and P = 0.047, respectively). Pairwise comparison revealed significantly lower PI and GI in the software group compared to the assistant group. No significant differences were found between the social media and other groups.

CONCLUSION

Our results suggest that the use of specially designed software could be the most effective strategy for improving oral hygiene in orthodontic patients. Meanwhile, traditional assistant-led education showed the least effectiveness. The study supports the potential benefit of utilizing digital tools, such as bespoke software and social media, in oral health education for orthodontic patients.

TRIAL REGISTRATION

The study was registered in the Iranian Registry of Clinical Trials (IRCT) database with the identification code IRCT20200609047705N2 in 13.07.2021.

A cross-sectional study to correlate oral hygiene habit among orthodontic patients with their clinical findings and periodontal treatment need

BACKGROUND

Orthodontic treatment requires good oral hygiene for successful completion of treatment. As protocol, patients are usually given instructions for oral hygiene and diet at the start of treatment, however, they are not fully followed. Different methods are employed in order to increase patient compliance including digital means, however, these are not possible in teaching hospitals with high burden of patient care and limited resources. The present study aims to correlate the patient reported behavior with their clinical findings and treatment need. This will enable us to identify potential sources of motivation which will be incorporated in daily practice and enable us to improve methods to enhance patient's behavior.

METHOD

A cross-sectional study was conducted in the orthodontic department of a semi-government teaching hospital from August to October 2023 using a modified questionnaire. The clinical examination was done using a Community Periodontal Index for Treatment Need-C (CPITN-C) probe. The diagnosis of presenting clinical conditions and treatment need was done using Community Periodontal Index for Treatment Need (CPITN) and Gingival Bleeding Index (BI). Data collected was analyzed for frequencies and correlation was done using Spearman Correlation Coefficient. P- value ≤ 0.05 was taken as statistically significant.

RESULT

The sample size consisted of 110 patients of which 60% were entitled to receive treatment. The predominant age group was 15-20 years (39.1%). Approximately 70% patients were in code 1 for CPITN and GI and in need of oral hygiene instructions. Overall patients' showed good level of awareness, however, they were not compliant in behavior.

CONCLUSION

Although patients showed a good level of awareness towards oral hygiene practices, there was a lack of compliance in following them. Patients were more concerned for being affected by dental caries due to poor oral hygiene than its effect on overall treatment outcome.

Patient adherence in orthodontics: a scoping review

BACKGROUND

Patient adherence is a key factor in achieving orthodontic treatment success. Despite an evolution in orthodontic healthcare, no recent comprehensive reviews are available on patient adherence in orthodontics. This scoping review provides an evidence-based overview of the literature available on multiple aspects of patient adherence in orthodontics, during both active treatment as well as during the retention phase. Knowledge gaps identified in the literature are listed.

METHODS

The protocol for this scoping review was registered in the Open Science Framework ( https://doi.org/10.17605/OSF.IO/EC6QD ). Electronic databases and reference lists of relevant studies were searched up to 9 February 2023. The inclusion criteria were studies investigating any form of patient adherence in orthodontics published in English from 2006 onwards. The exclusion criteria were studies investigating adherence in the following patients: those with an intellectual or physical disability that could affect their ability to coincide with their therapist's recommendations and advice, those with oral cleft and craniofacial conditions, and those treated solely for obstructive sleep apnoea. Non-peer-reviewed studies and case reports were also excluded.

RESULTS

A total of 3284 articles were identified, 60 of which met the criteria for final inclusion.

CONCLUSIONS

There is no conclusive evidence on which factors have a significant impact on patient adherence and how patient adherence can be promoted. The degree of patient adherence is generally not compared to achieved treatment results or stability of treatment results, making it difficult to provide clear statements about the impact of the degree of adherence on desired treatment results or orthodontic stability.

A comparison study: The use of digital and conventional impression techniques in dental hygiene education

PURPOSE/OBJECTIVES

The study aimed to assess the applicability of digital intraoral scanning in dental hygiene education and compare the quality, efficiency, and ease of use to conventional impression techniques.

METHODS

Twenty-eight first-year dental hygiene students (DH1) at UTHealth Houston School of Dentistry (UTSD) participated in this 2022 study. Each student participated in two 4-h lab sessions. Students took traditional alginate impressions and digital intraoral scans using Planmeca Romexis on standardized teeth during the first and second sessions. Both techniques were assessed by faculty for quality and efficiency using a standardized rubric. Participants completed a post-survey providing insight into their perceptions of both techniques and ease of use.

RESULTS

The study had 100% participation in the lab sessions and survey responses (N = 28). The results showed digital scanning produced a statistically higher quality product than conventional alginate impressions (p = 0.023). The study found no statistical difference in the efficiency between the two methods. The majority of students (82%) agreed that digital intraoral scanning was easy to use (p = 0.001), and 89% agreed they would use digital intraoral scanning in clinical courses to help with patient care (p = 0.03).

CONCLUSION

In this study, dental hygiene students with limited clinical experience learned new technology and used it to produce quality impressions compared to the conventional technique, indicating the value of introducing digital dentistry early in dental hygiene education.

Social media as a tool for oral health promotion: A systematic review

Social media platforms are common means of sharing information, personal experiences, and lifestyle. They can also be utilized as cost-effective methods for individuals to acquire health information and promote oral health. The purpose of the present study was to systematically review the current literature on the interventions taken through social media for promoting lay people's oral health. This systematic review (PROSPERO: CRD42023395005) followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. A comprehensive search was conducted in four electronic databases (PubMed, Scopus, Embase, and Cochrane Library) for relevant articles published between 2012 and 2023. Data such as study design, sample size, follow-up duration, utilized social media platforms and main findings were extracted from the eligible studies. The quality of the studies included in the systematic review was evaluated by the quality assessment tools for intervention studies recommended by the National Collaborating Centre for Methods and Tools. Out of the 1934 records identified in the initial search, 10 studies met the inclusion criteria and were included in the qualitative synthesis. These studies comprised seven randomized control trials, one field trial and two quasi-experimental. Various social media platforms, including Telegram, Instagram, YouTube, WhatsApp and Snapchat, were used for communication with patients. Some studies solely utilized social media interventions, while others combined online and traditional interventions. The quality assessment categorized 30% of the studies as "strong", 50% as "moderate", and the remaining as "weak". The implementation of social media interventions positively influenced multiple aspects of oral health among the laypeople. Online platforms such as YouTube, WhatsApp, Instagram, and Telegram can be effectively utilized to promote oral health among patients.

Improvement of oral health knowledge and behavior of diabetic patients: an interventional study using the social media

BACKGROUND

Diabetic patients are not often aware of relationship between diabetes mellitus (DM) and periodontal diseases, and the researchers recommend further knowledge enhancement of diabetic patients in this regard. This study aimed to enhance oral health knowledge of diabetic adults via an educational intervention.

METHODS

In this interventional study, three private offices of endocrinologists specialized in treatment of DM were selected for the recruitment of participants. In total, 120 diabetic adults (40 from each office) took part in an educational intervention in three groups (patients from each office made up one group): (I) physician-aid, (II) researcher-aid, and (III) social media. In group (I), participants received educational materials (brochure and CD) from their endocrinologist, in group (II) participants received educational materials from researcher. Group (III) joining an educational group in WhatsApp for 3 months. A self-reported standard questionnaire was filled out by the patients before, and after the intervention to assess oral health knowledge. Data were analyzed by SPSS version 21 using independent t-test, Mann-Whitney test, Chi-square test, and ANCOVA.

RESULTS

The mean oral health knowledge score increased in all three groups after the educational interventions (P < 0.001); the highest increase occurred in the social media group. Toothbrushing twice daily or more had the greatest improvement in the physician-aid group compared with the other two groups (P < 0.001). The greatest improvement in dental flossing once daily or more occurred in the social media group (P = 0.01). The mean level of the hemoglobin A1c (HbA1c) decreased in all three groups, but not significantly (P = 0.83).

CONCLUSION

The results showed that educational interventions enhance oral health knowledge, and improve the behavior of diabetic adults. The education via the social media can be an efficient method for knowledge enhancement of diabetic patients.

Leveling the curve of Spee using different sized archwires: a randomized clinical trial of blood flow changes

OBJECTIVES

To compare blood flow (BF) changes of teeth subjected to orthodontic forces during curve of Spee (COS) leveling using different archwires (AW).

MATERIAL AND METHODS

Thirty subjects with COS > 5 mm were randomly assigned (1:1:1) into three groups based on the AW used: group 1: 0.017 × 0.025-inch stainless-steel (SS)AW, group 2: 0.019 × 0.025-inch SSAW, and group 3: 0.021 × 0.025-inch β-titanium (TMA)AW. In the 3 groups, a 5 mm-depth reverse COS was placed in the AWs. A laser Doppler flowmeter was used to measure BF at different time intervals (T0-T4).

RESULTS

In the 3 AWs group, BF of all measured teeth was reduced 20 min after force application. Afterwards, the BF values started to increase until the baseline values were almost restored within 1 week. Differences in BF changes between the extrusion and intrusion subgroups were observed within groups 1 and 3 during the first 20 min of force application (P < 0.05). Similar BF changes were recorded using the 3 different AWs. BF changes were associated with tooth type and the amount of COS depth change.

CONCLUSIONS

During CoS leveling, similar BF changes were recorded using the 3 different AWs. Tooth type and the amount of COS depth change were associated with BF changes within the first 20 min of force application. Greater BF reduction was found in premolars compared to incisors during the first 20 min of AW placement.

CLINICAL RELEVANCE

It is important to select a type of applied forces that minimally affect the BF. Intrusive forces appeared to have lower negative effects on the BF of teeth during COS leveling.

TRIAL REGISTRATION

ClinicalTrial.gov (# NCT04549948).

Effectiveness of a New App in Improving Oral Hygiene in Orthodontic Patients: A Pilot Study

OBJECTIVES

The aim of this randomised clinical trial was to evaluate the effects of a mobile application (app) on the oral hygiene (OH) of adolescents undergoing fixed orthodontic treatment.

METHODS

Eight volunteers (14-19 years old) were randomly allocated to the experimental or control groups. Volunteers in the control group received standard OH (SOH) instructions, whilst volunteers in the experimental group received SHO + OH guidance and motivation through an app tailor-made for this study. Clinical assessments were made using the visible plaque index (VPI) and gingival bleeding index (GBI) at 5 different time points: before orthodontic device installation (T0); at baseline (T1); and 30 (T2), 60 (T3), and 90 (T4) days after randomisation. Significant differences were evaluated using Student t test and multilevel logistic regression analysis.

RESULTS

Although no significant difference could be observed, VPI at T1 and T2 were lower for volunteers in the experimental group (33.20 ± 19.29; 32.10 ± 7.72) than for the volunteers in the control group (42.11 ± 8.56; 43.59 ± 34.71). The same was observed for GBI, in which volunteers in the experimental group presented lower GBI at T1 and T2 (12.70 ± 8.10; 13.72 ± 7.39) than volunteers in the control group (27.53 ± 17.89; 20.38 ± 9.95). Good acceptance for using the app was shown by volunteers.

CONCLUSIONS

This study shows the potential utility of the mobile app for improving the OH of adolescents.

Does motivation via a smartphone application improve oral hygiene in patients undergoing orthodontic treatment?

DESIGN

This is a randomized cohort study.

COHORT SELECTION

The inclusion criteria comprised patients aged 14-19 years who started their orthodontic treatment using fixed appliances at the Orthodontic Clinic at Universidade Cruzeiro do Sul, San Paulo, Brazil. Only patients who had smartphones were included in this study. The exclusion criteria comprised patients who had previous orthodontic treatment, presence of any oral pathology, and chronic use of analgesic medication or presence of syndromes. Included patients were randomized to two groups (control and experimental).

DATA ANALYSIS

The oral hygiene of the included patients was evaluated clinically at five points in time: before bonding fixed orthodontic appliance (T0), immediately after randomization (T1), at 30 days after the beginning of the intervention (T2), at 60 days after the beginning of the intervention (T3), and at 90 days after the beginning of the intervention (T4). Oral hygiene was assessed using visual plaque index (VPI) and gingival bleeding index (GBI) at six sites of all teeth in every arch excluding third molars. Prior to the intervention, all patients who participated in this study underwent an oral hygiene session aimed to obtain a plaque index equal to zero and were given standardized oral hygiene instructions. Patients included in the control group were not given any structured oral hygiene follow-up in addition to the standard follow-up already established at the orthodontic clinic. Patients in the experimental group were instructed to install an application (A Dentista Cientista) that was designed especially for this study on their smartphones. This application aimed to guide and motivate patients daily in a playful way about performing oral hygiene practices. The application reminded the patients to perform their oral hygiene through an alarm.

RESULTS

A total of 11 patients were screened for study eligibility; 3 patients were excluded from the study. Eight patients were included in this study, four patients in each group. Although VPI and GBI values were reduced at T1 and T2 in the experimental group, there were no statistically significant differences for VPI and GBI between the groups at any time evaluated (P > 0.05). The patients who were included in the experimental group reported a good acceptability of the application and they would recommend it to other people. In addition, the patients who were included in the experimental group agreed that oral hygiene is crucial and 75% of them agreed that the application encouraged them to take better care of their oral health.

CONCLUSIONS

This study showed that mobile applications might help in improving the oral hygiene of orthodontic adolescent patients.

Clinical Applications for Dentistry and Oral Health

In the last few years, dentistry has expanded the scope of its research and increased its cooperation with other disciplines [...]

The Role of Social Media in Communication and Learning at the Time of COVID-19 Lockdown-An Online Survey

This study aimed to assess orthodontic postgraduate students' use of social media during the COVID-19 lockdown. Ninety-four postgraduate students (67 master's students and 27 doctoral students) were enrolled in the study and asked to fill in an online questionnaire by answering questions regarding their use of social media during the COVID-19 lockdown. The frequency distributions and percentages were calculated using SPSS software. The results showed that 99% of the students used social media. The most frequently used type of social media was Facebook, 94%, followed by YouTube, 78%, and Instagram, 65%, while Twitter and Linkedin were used less, and no one used Blogger. About 63% of the students used elements of social media to learn more about orthodontics staging, biomechanics, and various approaches in managing orthodontic cases. About 56% of students tried uploading and downloading scientific papers, lectures, movies, presentations, and e-books from social media, while communication with professionals and searches about orthodontic products were reported in 47% of students' responses. On the other hand, 43% of the responses favored sharing orthodontic information and posts for teaching and discussion purposes. Generally, social media plays leading roles in the communication with, learning of, sharing of information with, and supervision of patients from a far during the COVID-19 lockdown.

Knowledge and Perception of Orthodontic Treatment among General and Non-Orthodontic Dental Specialists: A Comparative Study

The objective of this study is to discover any possible association of gender or practitioner classification with orthodontic knowledge and attitudes towards orthodontic treatment. Descriptive cross-sectional research was conducted on two groups of dentists in the Ha'il region of Saudi Arabia. Group I included general practitioners, while Group II had non-orthodontic specialists. The findings suggest a statistically significant (p < 0.05) difference between the knowledge and attitudes of general practitioners and non-orthodontic specialists. Independent two tailed t-scores for difference in Knowledge (t-score = 3.19919, p = 0.003) and Attitude (t-score = 2.16314, p = 0.048319), highlight significant disparities in the knowledge and attitudes of general practitioners and non-orthodontic specialists. However, no statistically significant difference was observed in terms of knowledge and attitudes based on gender differences. This study captures and highlights subtle information that is very significant in dealing with critically important orthodontics issues. The study suggests that it is possible that a non-orthodontic specialist may suggest an altogether different line of treatment with different consequences when compared to a general practitioner and vice versa. This may result in unwanted, permanent orthodontic effects, highlighting the significance of the early stage of orthodontic treatment awareness. This research reveals disparities between the perceptions of general practitioners and non-orthodontic specialists about the stage and relevance of orthodontic treatment. It is strongly advised to see an orthodontic expert rather than a general practitioner or non-orthodontic specialist for orthodontic issues.

L. Shayeb M. Future of Orthodontics-A Systematic Review and Meta-Analysis on the Emerging Trends in This Field

Technology is rapidly evolving in the modern world, and the accompanying developments due to its influence are shaping each and every aspect of our life, with the field of orthodontics being no exception. This systematic review and meta-analysis aimed to examine such trends in orthodontics and hypothesize which ones would emerge and continue in the near future. After a thorough search of online journals using keywords such as "3D printing," "Aligners," "Artificial intelligence," "Future trends," "Orthodontics," and "Teleorthodontics" across databases of PubMed-MEDLINE, Web of Science, Cochrane, and Scopus, a total of 634 papers were initially recovered. Technological advancements in 3D printing, Computer-aided design and Computer-aided manufacturing (CAD/CAM), biopolymers and Teleorthodontics were the most important categories of development seen across the 17 studies that we selected for our review. All the investigations selected for this systematic review depicted aspects of orthodontics that were influenced by rapid technological changes and could potentially become mainstream in the coming times. However, caution was sought to be observed in the usage/adoption of some of these trends, with social media usage amongst both patients as well as orthodontists being a prime example of this.

Parents' Awareness of Malocclusion and Orthodontic Consultation for Their Children: A Cross-Sectional Study

Parents' awareness of malocclusion and the appropriate timing to seek orthodontic consultation for their children has a substantial impact on children's orthodontic treatment. This cross-sectional study aims to investigate parents' awareness of malocclusion and orthodontic consultation of their children and the influence of parents' demographics on their awareness level. An electronic survey collected information about participants' demographics and awareness about malocclusion and orthodontic consultation of children. A total of 473 parents living in Jeddah, Saudi Arabia, participated in the study. The average awareness level among parents was moderate (3.09 ± 1.4). Male gender and unemployment were associated with low orthodontic awareness levels relative to moderate awareness (OR = 3.3, 95% CI = 1.8-5.8 and OR = 2.1, 95% CI = 1.1-3.8, respectively). Former or current orthodontic treatment was associated with high awareness levels (OR = 3.9, 95% CI = 2.4-6.5). There is still a need to raise the awareness of Saudi parents about malocclusion and orthodontic consultations for their children. Orthodontic awareness-raising campaigns should be designed to include fathers and parents with low socioeconomic status. The findings of this study also suggest that orthodontists can enhance their patient's awareness of malocclusion and orthodontic consultation for their children.

Predictability of Invisalign® Clear Aligners Using OrthoPulse®: A Retrospective Study

This preliminary retrospective study evaluates how effective the OrthoPulse^® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign^® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign^® orthodontic clear aligners in association with an OrthoPulse^®. The OrthoPulse^® was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse^® App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse^® led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse^® needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse^® would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements.

Effectiveness of Smart Applications of Oral Hygiene Instructions on Periodontal Health Compared to Oral Information: A Prospective Study

Nowadays, smartphone applications are widely used in different areas of life, including medical science. The present study aimed to assess the effectiveness of a smartphone application of oral hygiene instructions (OHI) on periodontal health compared to the traditional chairside OHI. All the participants (n = 39) were divided into two groups: control group and test group. Participants of the control group were given verbal OHI and participants of the test group were asked to use a smartphone application to upkeep their oral habits. The gingival index (GI) and Quigley-Hein Turesky modification index (QHTMI) were used for scoring the plaque accumulation at baseline and after one month of the periodontal treatment. A paired t-test and an independent t-test were performed to compare the mean of GI and QHTMI between intra-group and inter-group, respectively. The paired t-test showed significant differences in GI and QHTMI improvement after one month in both groups. Moreover, the independent t-test showed no significant differences between the two groups. However, the test group showed a lower mean score in GI and QHTMI assessments compared to the control group. Smartphone applications in oral health applications did not exhibit any superiority in periodontal health over the traditional OHI method in the current study.

Revisiting Provider Communication to Support Team Cohesiveness: Implications for Practice, Provider Burnout, and Technology Application in Primary Care Settings

Background

Effective team communication is an essential aspect of care delivery and the coordination of patients in primary care settings. With the rapid evolution of health information technology (HIT), including the implementation of electronic health records, there remains a gap in the literature about preferred methods of primary care team communication and the subsequent impact of provider and team outcomes (e.g., team cohesiveness; burnout). This study explores the impact of varying modes of communication across provider disciplines and by geographic settings during primary care delivery.

Methods

We used a cross-sectional survey design to collect data from a random convenience sample of PCPs (physicians, nurse practitioners, and physician assistants) (n = 314) in New York State (NYS). We mailed a paper survey with validated measures for communication methods, team cohesiveness, and provider outcomes (burnout, job dissatisfaction, and the intention to leave position). Descriptive statistics, linear regression models, and crude and adjusted odds ratios while controlling for individual and practice characteristics were calculated.

Results

In-person communication was found to yield greater job satisfaction and less intention to leave current position in the next year (p=0.02) compared to other forms of communication including electronic health record features. The odds of job satisfaction was 1.51 times higher with in-person communication (OR: 1.51, 95% CI: 1.05, 2.19), and the odds of intending to leave a position was 45% less with in-person communication (OR: 0.55, 95% CI: 0.36, 0.85). The odds of reporting burnout at work was 36% less with in-person communication (OR: 0.64, 95% CI: 0.43, 0.92) compared to other communication modalities. There was no significant association between team communication via the EHR and team cohesiveness, provider burnout, or job satisfaction.

Conclusion

This study demonstrates evidence that in-person communication is more likely to reduce burnout and job dissatisfaction compared to other forms of communication infrastructure in primary care settings. More research is needed to understand PCP perspectives about the functionality and potential burden that inhibits the use of EHR features for provider-provider communication. In addition, attention to the needs of teams by geographic location and by workforce discipline is warranted to ensure effective HIT communication application adoption.

A Video-Game-Based Oral Health Intervention in Primary Schools—A Randomised Controlled Trial

Background: Poor oral health practices and high levels of dental caries have been reported among children in the developing world. Video games have been successful in promoting oral health in children. The aim of this study was to assess the impact of an oral-health-education video game on children’s dietary knowledge and dietary and toothbrushing practices; Methods: Two Schools in Amman, Jordan were randomly selected and assigned to either intervention or control. Six- to eight-year old children took part. The intervention group played the oral-health-education video game; the control group received no intervention. The groups were compared in terms of changes in: child dietary knowledge, dietary and toothbrushing practices, plaque scores, and parental familiarity with preventive treatments. Data were submitted to statistical analysis with the significance level set at p ≤ 0.05. Results: Two hundred and seventy-eight children took part. Most (92%) had carious teeth. At baseline, children reported having more than one sugary snack a day and only 33% were brushing twice a day. Most parents were unaware of fluoride varnish (66%) or fissure sealants (81%). At follow-up, children in the intervention group had significantly better dietary knowledge, and parents in both groups became more familiar with fluoride varnish. There were no significant changes in children’s plaque scores, toothbrushing and dietary practices, or parental familiarity with fissure sealants in either group. Conclusions: Using an oral-health-education video game improved children’s dietary knowledge. However, future efforts should target children together with parents, and need to be supplemented by wider oral-health-promotion.

Utilization of a 3D Printed Orthodontic Distalizer for Tooth-Borne Hybrid Treatment in Class II Unilateral Malocclusions

This paper introduces a novel method of 3D designing and 3D printing of a hybrid orthodontic tooth-borne personalized distalizer for treatment of unilateral Class II malocclusion. Research objectives were to clinically utilize 3D printed distalizers, appraise feasibility of this technique and compare two different biocompatible photopolymers (white and transparent). Frequency of distalizers’ debonding and patients’ aesthetical perception was evaluated on the set of 12 complete orthodontic treatments. The mean duration of treatment period with a bonded distalizer was 6.4 months. All cases were adults with unilateral Class II malocclusion managed with a hybrid approach as a part of Invisalign® comprehensive treatment. Results showed that such perspective practice is feasible for 3D design and in-office 3D printing of a personalized distalizer. Results also showed no clinically significant differences between both studied biopolymers. The paper discusses an evaluation of such personalized distalizer functionality with regard to the current state of the art and compares to conventional prefabricated alternatives like a Carriere® Distalizer™ appliance. Research showed a preference of patients towards transparent biocompatible photopolymer instead of the white A2 shade. The paper concludes that additive manufacturing from dental resins is a viable method in personalization and in-office 3D printing of orthodontic auxiliaries, particularly distalizers. New materials for orthodontic 3D printing endow enhanced individualization, thus more efficient treatment.

Artificial Intelligence in Orthodontic Smart Application for Treatment Coaching and Its Impact on Clinical Performance of Patients Monitored with AI-TeleHealth System

BACKGROUND

Treatment of malocclusion with clear removable appliances like Invisalign^® or Spark™, require considerable higher level of patient compliance when compared to conventional fixed braces. The clinical outcomes and treatment efficiency strongly depend on the patient's discipline. Smart treatment coaching applications, like strojCHECK^® are efficient for improving patient compliance.

PURPOSE

To evaluate the impact of computerized personalized decision algorithms responding to observed and anticipated patient behavior implemented as an update of an existing clinical orthodontic application (app).

MATERIALS AND METHODS

Variables such as (1) patient app interaction, (2) patient app discipline and (3) clinical aligner tracking evaluated by artificial intelligence system (AI) system-Dental monitoring^® were observed on the set of 86 patients. Two 60-day periods were evaluated; before and after the app was updated with decision tree processes.

RESULTS

All variables showed significant improvement after the update except for the manifestation of clinical non-tracking in men, evaluated by artificial intelligence from video scans.

CONCLUSIONS

Implementation of application update including computerized decision processes can significantly enhance clinical performance of existing health care applications and improve patients' compliance. Using the algorithm with decision tree architecture could create a baseline for further machine learning optimization.

The influence of mobile applications and social media-based interventions in producing behavior change among orthodontic patients: A systematic review and meta-analysis

INTRODUCTION

The objective of this project was to systematically review the effectiveness of mobile applications and social media-based interventions in producing a behavioral change in orthodontic patients.

METHODS

Electronic databases and reference lists of relevant studies were searched on March 1, 2021, with no language restrictions (PROSPERO: CRD42019157298). Randomized and nonrandomized controlled trials assessing the impact of mobile applications and social media-based interventions on orthodontic patients were identified. Primary outcomes included adherence to wear, appointment attendance, knowledge, oral health-related behaviors, oral hygiene levels, periodontal outcomes, and related iatrogenic effects. The quality of the included trials was assessed using the Cochrane risk of bias tools. A weighted treatment effect of interventions on periodontal outcomes was calculated. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system.

RESULTS

A total of 3617 articles were identified. Of these, 16 studies (14 randomized controlled trials and 2 nonrandomized controlled trials) were deemed eligible. Nine randomized controlled trials were judged to be of either low or unclear risk of bias. The intervention was favored in relation to gingival and plaque indexes, standardized mean difference: -0.81 (95% confidence intervals [CI], -1.35 to -0.28) and -0.91 (95% CI, -1.64 to -0.19), respectively. However, no significant effect was observed in bleeding on probing (standardized mean difference: -0.22; 95% CI, -0.5 to 0.05). The level of evidence was high in probing depth and bleeding on probing outcomes.

CONCLUSIONS

A very low to moderate level of evidence supports the effects of mobile applications and social media-based interventions in producing positive behavioral changes in orthodontic patients. Further high-quality trials would assist in further elucidating the potential of these approaches to influence orthodontic treatment outcomes and experiences.

Does Emotional Intelligence of Dental Undergraduates Influence Their Patient Satisfaction?

Objectives

The research aimed to investigate if emotional intelligence (EI) scores of dental undergraduates influenced their patients' satisfaction with the treatment received.

Methods

A 33-item EI questionnaire was completed by 46 dental undergraduates in a cross-sectional study. Responses, measured on a five-point Likert scale, were summed to yield EI scores. Patients treated by the same undergraduates were invited to complete a patient satisfaction (PS) questionnaire. EI and PS scores were calculated and compared by undergraduates' gender and the patients' age and education status. The four EI factors (optimism/mood regulation, appraisal of emotions, utilization of emotions, and social skills of students) were correlated with PS using Spearman's correlation test with a significance level set at p < 0.05.

Results

EI scores did not differ significantly between male (N = 23) and female (N = 23) undergraduates (p=0.218). PS was not associated with patients' gender, but those educated to the secondary school level were more likely to be satisfied compared to those educated to the college/university level (p=0.022). Of the four EI factors, optimism/mood regulation was positively correlated with PS (p=0.049).

Conclusion

The results of the study suggest that the EI of the students can influence PS. Practical Implications. Interventions to enhance EI can be developed to improve the patient experience.

Effects of remote digital monitoring on oral hygiene of orthodontic patients: a prospective study

Background

Remote digital monitoring during orthodontic treatment can help patients in improving their oral hygiene performance and reducing the number of appointments due to emergency reasons, especially in time of COVID-19 pandemic where non-urgent appointments might be discouraged.

Methods

Thirty patients scheduled to start an orthodontic treatment were divided into two groups of fifteen. Compared to controls, study group patients were provided with scan box and cheek retractor (Dental Monitoring®) and were instructed to take monthly intra-oral scans. Plaque Index (PI), Gingival Index (GI), and White Spot Lesions (WSL) were recorded for both groups at baseline (t₀), every month for the first 3 months (t₁, t₂, t₃), and at 6 months (t₄). Carious Lesions Onset (CLO) and Emergency Appointments (EA) were also recorded during the observation period. Inter-group differences were assessed with Student's t test and Chi-square test, intra-group differences were assessed with Cochran’s Q-test (significance α = 0.05).

Results

Study group patients showed a significant improvement in plaque control at t₃ (p = 0.010) and t₄ (p = 0.039), compared to control group. No significant difference was observed in the number of WSL between the two groups. No cavities were detected in the study group, while five CLO were diagnosed in the control group (p = 0.049). A decreased number of EA was observed in the study group, but the difference was not significant.

Conclusions

Integration of a remote monitoring system during orthodontic treatment was effective in improving plaque control and reducing carious lesions onset. The present findings encourage orthodontists to consider this technology to help maintaining optimal oral health of patients, especially in times of health emergency crisis.