Does oral health counseling effectively improve oral hygiene of orthodontic patients

Aim The aim of this study was to compare the effectiveness of oral health counseling sessions with traditional oral hygiene education in orthodontic patients with fixed appliances. Materials and methods Study design: randomised control trial with experimental and control group. A group of 99 adolescents with fixed orthodontic appliances were randomly assigned to oral health counseling (experimental) or traditional health education (control) group. Subjects in the control group received verbal instructions and a demonstration of the modified Bass brushing technique on a model. The experimental group also received the verbal information with demonstration on the model and in addition a personalised 40-minutes counseling session on oral hygiene. Plaque Index (PI) and gingivitis (G) were recorded before, 1 and 6 months after the counseling session/traditional education. Results Oral health counseling and traditional education improved the oral hygiene of orthodontic patients. PI values were significantly lower after 6 months compared to the baseline in both groups, but the prevalence of gingival inflammation remained significantly lower only in the experimental group. Conclusion Oral health counseling increased plaque removal efficacy and control of gingival inflammation. The efficiency of counseling and traditional education Does oral health counseling effectively improve oral hygiene of orthodontic patients? Introduction Orthodontic treatment increases the risk of carious lesions and gingival inflammation, with consequent harm to the patient and a high risk of compromising treatment outcome Lucchese et al., 2001; Lucchese and Storti, 2011]. Caries risk is related to appliances which increase the number of sites where plaque can accumulate, as well as to changes in the bacterial flora and the age of the patient [Opsahl et al., 2010]. Gingival inflammation is also a common finding in orthodontic patients. The severity of gingival inflammation is in correlation with oral hygiene status because oral cleaning procedures are more difficult in presence of orthodontic appliances and their components [Baricevic et al., 2011]. Before starting orthodontic treatment, individual caries risk should be determined, and according to its results adequate preventive measures should be applied [Todd et al., 1999; Madlena et al., 2000; Benson et al., 2005]. Patients need to be educated how to maintain proper oral hygiene in order to prevent negative side effects of orthodontic appliances [Turkkahraman et al., 2005]. Authors reported that oral hygiene motivation methods used in dental education can affect the outcome of treatment. Educational methods are generally classified as verbal [Huber et al., 1972; Boyd, 1983; Yeung et al., 1989], written [McGlynn et al., 1987] or visual-based [Lees and Rock, 2000]. A demonstration of the brushing technique with a model, supported by verbal instructions, illustrations catalogue or instructional video, followed by supervised application by the patient, seems to be the most effective method for patients to adopt any brushing technique [Addy et al., 1999; Renton-Harper et al., 1999; Yetkin et al., 2007]. In recent years, there have been attempts to integrate cognitive behavioural techniques with interventions targeting cleaning behaviour by forming action plans for when, where and how to perform daily self-care [Jonsson et al., 2006; Schuz et al., 2006; Sniehotta et al., 2007]. Individual brushing recommendations should be targeted to individual goals and problems. One of the cognitive– behavioural techniques applied to dental education was similar. Counseling is a promising approach that warrants further attention in a variety of dental