Improving Home Oral Hygiene in Patients with Fixed Orthodontic Appliances. Evaluating Educational and Motivational Interventions

Fixed orthodontics presents significant challenges in maintaining proper at-home oral hygiene. The presence of irregular surfaces, which favor bacterial accumulation, makes it difficult to control plaque effectively, thereby increasing the risk of developing various oral diseases. In this context, education and motivation are crucial for improving at-home oral hygiene in patients undergoing fixed orthodontic treatments. This systematic review aimed to evaluate the effects of education and motivation on the plaque index of patients with fixed orthodontic appliances. A search was conducted using the PubMed and Cochrane Library databases. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and included randomized controlled trials (RCTs). They had to assess treatment with fixed and home oral hygiene protocols. The p-value was analyzed by comparing the experimental and control groups, as well as the Plaque Index (PI) of the two groups at each follow-up. After a careful selection process, nine studies met the inclusion and exclusion criteria and were included in the review. The results from these studies show that repeated educational and motivational strategies, delivered through both traditional and digital methods, lead to a reduction in the plaque index among patients who received support compared to control groups. In fact, six out of nine studies show a statistically significant difference in terms of PI for the experimental group. This systematic review highlights the importance of educational and motivational interventions in helping patients maintain effective plaque control, a crucial aspect of oral health for individuals wearing fixed orthodontic appliances. Digital tools offer a promising avenue for enhancing adherence among orthodontic patients and reducing the risk of plaque-related conditions.