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Completed

NCT Number: NCT07835022

Smartphone App Versus Verbal Motivation for Oral Hygiene in Fixed Orthodontic Patients

This study looked at whether a smartphone app can help patients with fixed braces keep their teeth cleaner than usual spoken advice alone. Fixed braces make plaque harder to remove, which can harm the teeth and gums, so good brushing habits matter.

Fifty patients aged 14 to 22 were divided at random into two groups. One group used a purpose-made app ("iTeeth Orthodontics") that sent brushing reminders, timed brushing, and kept a brushing log. The other group received the usual spoken oral-hygiene motivation. Both groups used the same brushes, toothpaste, and rinse, and followed the same cleaning routine.

Plaque was measured from photographs at 10 days and at 1, 2, and 3 months, using a computer to calculate how much of each tooth surface was covered by plaque. The two groups were then compared.

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Key information

Conditions

Dental Plaque Behavior Dental Deposits Gingival Diseases Gingivitis Health Behavior Infections Malocclusion Mouth Diseases Oral Hygiene Oral Hygiene and Plaque Control During Fixed Orthodontic Treatment Patient Acceptance of Health Care Patient Compliance Periodontal Diseases Stomatognathic Diseases Tooth Diseases Treatment Adherence and Compliance

Age range

14 year–22 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ondokuz Mayıs University, Faculty of Dentistry, Department of Orthodontics

Samsun, 55139, Turkey (Türkiye)

About this study

ackground and objective: Maintaining oral hygiene during fixed orthodontic treatment is difficult, and patient motivation is central to preventing plaque accumulation, enamel demineralization, and gingival inflammation. This trial compared a purpose-built smartphone application with conventional verbal motivation for plaque control during fixed orthodontic treatment.

Design: Prospective, randomized, controlled, parallel-group (1:1) in vivo trial conducted at the Department of Orthodontics, Faculty of Dentistry, Ondokuz Mayıs University (Samsun, Türkiye). Fifty patients (14-22 years) with Class I or II malocclusion who owned and used a smartphone were enrolled and allocated equally to a mobile group (app plus standard regimen) or a control group (verbal motivation plus the identical regimen).

Intervention: The "iTeeth Orthodontics" application provided treatment information, customizable brushing reminders (push notifications), an adjustable brushing timer with interdental-brush and mouthrinse prompts, and a daily/weekly/monthly brushing log. Both groups used identical brackets, archwires, toothbrushes, interdental brushes, toothpaste, and mouthrinse, and followed the same oral-hygiene regimen (modified Bass brushing three times daily, nightly interdental cleaning, and mouthrinse), so that the motivational method was the only variable.

Outcome and assessment: Plaque was recorded at day 10 (T0) and at 1 (T1), 2 (T2), and 3 (T3) months. After application of a disclosing agent, standardized intraoral photographs were taken, and the disclosed plaque area on the maxillary central incisors, canines, and second premolars was quantified by computer-assisted planimetry as a percentage of the total visible buccal crown surface. The outcome assessor was blinded to group and time point. Between-group and over-time comparisons were then performed.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

* Aged 14-22 years

  • Accepted for fixed orthodontic treatment
  • Skeletal and/or dental Class I or Class II malocclusion
  • Owns and regularly uses a smartphone
  • Completed permanent dentition
  • No systemic disease and no continuous (long-term) medication

Exclusion criteria

* Skeletal malocclusion severe enough to require orthognathic (surgical) treatment

  • Motor, physical, or mental impairment interfering with toothbrushing
  • Congenitally missing or pre-treatment extracted teeth
  • Impacted or supernumerary teeth
  • Teeth with shape anomalies -

Treatment and study plan

Smartphone application for oral-hygiene motivation (iTeeth Orthodontics)

Behavioral

Purpose-built smartphone application supporting oral hygiene during fixed orthodontic treatment. It provides treatment information, customizable brushing reminders (push notifications), an adjustable brushing timer that prompts interdental-brush use and mouthrinse at the end of each session, and a daily/weekly/monthly brushing log, used alongside the standardized oral-hygiene regimen common to both groups.

Conventional verbal oral-hygiene motivation

Behavioral

Standard chairside verbal oral-hygiene motivation and instruction, delivered without the smartphone application, alongside the same oral-hygiene regimen and materials (toothbrush, interdental brush, toothpaste, mouthrinse; modified Bass brushing three times daily, nightly interdental cleaning, and mouthrinse) provided to both groups.

Primary outcomes

  1. Dental plaque percentage (computer-assisted planimetry)

    Time frame: Day 10 (T0, baseline) and at 1 month (T1), 2 months (T2), and 3 months (T3)

    Amount of dental plaque expressed as the disclosed plaque area as a percentage of the total visible buccal crown surface. After application of a plaque-disclosing agent, standardized intraoral photographs were taken and the plaque area on the maxillary central incisors, canines, and second premolars was quantified by computer-assisted planimetry. Lower values indicate less plaque (better oral hygiene). The outcome assessor was blinded to group and time point.

Secondary outcomes

  1. Tooth-type-specific dental plaque percentage

    Time frame: Day 10 (T0) and at 1 month (T1), 2 months (T2), and 3 months (T3)

    Plaque percentage (disclosed plaque area as a percentage of the total visible buccal crown surface, by planimetry) analyzed separately for maxillary central incisors, canines, and second premolars, and within-group change over the follow-up period.

Sponsors and collaborators

Lead sponsor

Atlas University

Other

Registry information

Official study title

Effectiveness of a Smartphone Application Versus Conventional Verbal Motivation on Oral Hygiene in Patients Undergoing Fixed Orthodontic Treatment: A Randomized Controlled Trial

Acronym: iTeeth

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Sep 22, 2026
Registry last updated
Sep 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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