IMPROVING ORAL HYGIENE IN ADOLESCENT ORTHODONTIC PATIENTS WITH SBIRT-BASED INTERVENTION

Abstract

Objective: The aim of this study was to determine the effectiveness of an SBIRT-modeled intervention on improving oral hygiene in adolescent orthodontic patients with fixed appliances. Methods: A prospective, randomized trial was designed to evaluate the effectiveness of an SBIRT-inspired strategy aimed at improving oral hygiene. Subjects were recruited from patients undergoing orthodontic treatment at the Temple University Kornberg School of Dentistry, Department of Orthodontics. The subjects were in the permanent dentition, and were being treated with full fixed appliances in both arches. Subjects were screened for caries risk, and individuals with moderate-high risk for caries were allocated randomly to either a control (traditional oral hygiene instruction) or intervention (SBIRT protocol) group. Plaque (PI) and gingival index (GI) scores were collected at baseline (T0), 1-2 month follow-up (T1), and 3-4 month follow-up (T2). At the T1 follow-up, those non-responsive to the intervention were referred for treatment by a hygienist. Subjects also completed a pre- and post-intervention survey to evaluate change in homecare habits and self-assessment of hygiene. Results: A total of 25 (15 female, 10 male) patients were recruited for the study and had baseline (T0) data collected. The majority of the sample was female (60.0%) and African American (68.0%), and the average age of the sample was 13.6±1.5 years. Regarding caries risk, 64.0% were classified as high risk, while 36.0% had moderate risk. No significant differences in baseline scores were observed between the two trial arms for key demographics. Of the initial 25 subjects, 19 (7 control, 12 intervention) had T1 data collected. The mean PI and GI scores for both groups improved from T0 to T1. There were greater differences between T0 to T1 for the SBIRT group when compared to the control: PI improved 0.36±0.44 for the intervention group and 0.18±0.45 for the control group; GI improved 0.50±0.28 for the intervention group and 0.09±0.37 for the control group. Brushing and flossing frequency also increased for both groups. Conclusions: The SBIRT intervention group had greater improvement in oral hygiene than traditional oral hygiene instruction after a 1-2 month follow up. An MI protocol for improving oral hygiene in adolescent patients undergoing fixed orthodontic treatment shows promise in changing patient behaviors and outlook in regards to oral health. However, due to small sample size and significant loss to follow-up as a result of school and clinic closures due to the novel coronavirus (SARS-Cov-2), a more extensive study with a larger sample size is necessary to definitively prove the effectiveness of MI in improving oral hygiene.