Adolescent Compliance with Oral Hygiene Instructions during Fixed Orthodontic Treatment

Introduction: Maintaining good oral hygiene (OH) during fixed orthodontic treatment is of particular importance for the health of the gingival tissues because bonded orthodontic appliance attachments are sites of plaque accumulation. Orthodontic patients routinely receive OH instructions (OHI) before treatment. Yet, levels of patient compliance with such instructions and the factors that may predict compliance are unknown. Objectives: (1) To determine the level of compliance with OHI of 12-16-year old adolescents receiving fixed orthodontic treatment at the University of Toronto Graduate Orthodontic Clinic; (2) To identify factors predicting patient compliance with OHI. Methods: Design: Longitudinal pilot study using questionnaires and objective direct and indirect measures of compliance. All subjects are provided standardized OHI to be followed during their fixed orthodontic treatment. Patients are assessed at baseline T1: before receiving bonded orthodontic appliances; T2: 30 days after; and T3: 120 days after receiving bonded appliances. After training and calibrating the investigator to replicate the clinical settings of the study, OH is measured using plaque (PI) and gingival indices (GI). The factors predicting compliance are identified from questionnaires administered to the patients and their parents, and from the patients' clinical charts regarding appointment punctuality and appliance maintenance. Results: Preliminary results (N=28) showed that the mean and standard deviation of PI and GI at T1 were 1.08+0.647 and 0.927+0.512 respectively. More than 85% of the patients brush twice a day and only 40% use dental floss. As reported, 80% visited the dentist within the last year and the most common reasons for their visits were regular check-ups (44%) and teeth cleaning (33%). As reported by the parents, 60% of the parents completed post-high school education and the majority (82%) had low to moderate annual household income. Conclusion: Detailed results of the sample presently under study will be described at the time of presentation.