Effectiveness of Video‐Based Oral Hygiene Education Reinforcement During Fixed Orthodontic Treatment in Adults: A Randomised Clinical Trial

Objectives This study evaluated the effectiveness of supplementing standard verbal oral hygiene instruction (OHI) with on‐site or remote video‐assisted oral hygiene education (VOHE) for orthodontic patients, and the effects of discontinuing VOHE. Methods Forty‐eight participants (aged ≥ 18 years) undergoing fixed orthodontic treatment were recruited for this three‐arm single‐blind clinical trial and randomised into three groups: (i) control (verbal OHI only), (ii) on‐site VOHE plus verbal OHI and (iii) remote VOHE (via WhatsApp) plus verbal OHI. Oral hygiene assessments were conducted at baseline (T0) and every six to eight weeks for six follow‐ups (T1–T6). VOHE continued until T3 and was withdrawn at T4. The Orthodontic Plaque Index (OPI) and Full‐Mouth Bleeding Score (FMBS) were measured by the primary investigator, while interventions were conducted by an independent investigator. Analysis followed an intention‐to‐treat approach. Paired t ‐test, one‐way and two‐way repeated ANOVA were used to analyse the results ( p < 0.05). Results Before VOHE withdrawal, the control group showed no significant OPI reduction ( p = 0.132), while both VOHE groups demonstrated significant reductions (on‐site: p < 0.001; remote: p = 0.006). FMBS decreased significantly across all groups ( p < 0.001). After withdrawal, OPI increased in the remote group ( p = 0.006) but remained stable in others. FMBS increased in all groups, though not significantly. No significant OPI or FMBS differences were found between groups after withdrawal. Conclusions Routine verbal reinforcement alone is inadequate for sustained oral hygiene. VOHE enhances effectiveness, with on‐site delivery potentially offering better long‐term benefits due to supervision.