Effect of various active reminders via mobile phone on cooperation of orthodontic teenage patients regarding oral hygiene and Class II elastics use A three-month follow-up prospective cohort study

Abstract

Introduction The purpose of this prospective cohort study was to assess the impact of reminders via mobile phone, such as text messages or video/multimedia images, on orthodontic patients' cooperation with regard to oral hygiene and the use of Class II intermaxillary elastics. Methods The study included 124 orthodontic patients aged 12-20 years (mean age 14.06 +/- 2.0 years, 63 females and 61 males). The patients were divided into two groups: group 1 (n = 56) was evaluated for oral hygiene, while group 2 (n = 68) was evaluated for the use of Class II intermaxillary elastics. Each main group was divided into three subgroups: text message group, video message group, and control group. Specific messages were sent to the participants in the study groups twice a week for 12 weeks. Data were collected at the beginning of the study (T0), after 6 weeks (T1), and 12 weeks (T2) and compared to determine the impact of the reminders. Oral hygiene was evaluated using plaque and gingival index scores, and the use of Class II elastics was evaluated using digital model measurements. Between-subject comparisons were performed using Kruskal-Wallis or one-way analysis of variance (ANOVA). For within-subject comparisons (T0-T1, T1-T2, and T0-T2 time intervals), one-way repeated measures ANOVA or Friedman test was performed. Results There was no significant difference between the control group (1.49 +/- 0.22) and the message groups (video: 1.58 +/- 0.34 and text: 1.51 +/- 0.28) in terms of plaque index scores and gingival index (control: 1.56 +/- 0.26, text: 1.51 +/- 0.36, video: 1.52 +/- 0.26) scores. However, in the intragroup comparison, it was observed that both plaque index scores and gingival index scores at T0, T1, and T2 increased for both the study and control groups. While there was no difference between the subgroups in overjet measurement at T0 (control: 3.46 +/- 1.20, video: 3.34 +/- 1.20, text: 2.73 +/- 1.03; p = 0.51), there was a significant difference at T2 (control: 2.62 +/- 0.85, video: 2.32 +/- 1.41, text: 1.48 +/- 0.72, p < 0.01). Conclusion Mobile active reminders had no effect on improving oral hygiene. Despite repeated reminders, hygiene worsened over time. The use of Class II elastics seemed to have increased as a result of the mobile reminders.