Evolution of the effects of e-tel smartphone application on oral hygiene motivation and behavior change in patients receiving orthodontic treatment

Aim: The aim of this study is to evaluate the effect of a smartphone application developed to improve the oral hygiene motivation of patients receiving fixed orthodontic treatment on oral hygiene motivation and behavior change compared to traditional verbal hygiene motivation. Materials and Methods: Fifty patients between the ages of 13 and 21, with skeletal and/or dental Class I malocclusion, using a smartphone, and with completed permanent dentition were included in our study. The patients were divided into two groups: the mobile group, which was given the smartphone application called "eTel", and the control group, which was given verbal hygiene motivation. On the 1st day (T0), 1st month (T1), 2nd month (T2) and 3rd month (T3) of fixed orthodontic treatment, canine teeth, right and left upper lateral teeth were stained with a plaque staining tablet and intraoral clinical photographs were taken. SPSS 27 (Statistical Package for the Social Sciences) program was used for statistical analysis. Descriptive statistical methods (mean, standard deviation, median, frequency, percentage, minimum, maximum) were used when evaluating the study data. The suitability of quantitative data for normal distribution was tested using the Shapiro-Wilk test and graphical analysis. Student-t test was used for comparisons of normally distributed quantitative variables between two groups, and Mann-Whitney U test was used for comparisons of non-normally distributed quantitative variables between two groups. Repeated measures analysis of variance was used for intragroup comparisons of normally distributed quantitative variables, and Bonferroni corrected pairwise evaluations were used for evaluations of pairwise comparisons. Results: The use of mobile applications increased patients' cooperation with treatment. Considering the intergroup evaluation, the changes in gingival index, bleeding index and plaque index values of the study group cases at T1, T2 and T3 time points were found to be statistically significantly lower than the control group cases. Conclusion: The results of this study show that the use of a smartphone application developed to improve the oral hygiene motivation and oral health of patients receiving fixed orthodontic treatment during the treatment affects the users' oral hygiene motivation and oral health more positively than verbal expression. Keywords: Orthodontic treatment, oral hygiene, smartphone application