Malocclusion, Compliance, Patient
Conditions
Keywords
Intraoral elastics
Brief summary
Fixed orthodontic appliances in combination with intraoral elastics are a common and effective method use in the orthodontic correction of malocclusions. However, their success is largely dependent on the patient's compliance. Failure to wear the elastics as instructed will reduce efficacy of treatment, ultimately increasing treatment time and potentially producing imperfect alignment of teeth. The hypothesis tested is that daily electronic reminders via a mobile application can significantly increase patient compliance, thus effectively improving treatment outcomes.
Detailed description
Despite advancements in various aspects of orthodontic treatment, patient compliance remains a critical factor in attaining a successful treatment outcome. More specifically, patient compliance in the use of intraoral elastics is an important component of the treatment plan of certain patients. Failure to wear elastics as directed will ultimately result in increased treatment time, and imperfect alignment of the teeth. Persuading adolescent orthodontic patients to wear intraoral elastics consistently is difficult in the short appointment times of a typical practice. Studies have shown that adolescents respond at a higher level to a more constant form of communication, as well as a method more closely associated with their generation. As smartphones have become an everyday appliance for most of the general public, mobile applications (apps) have the capability to serve as an effective avenue for communication between doctor and patient. Recent studies in both dentistry and medicine have reported that active reminders via mobile phone improve appointment attendance, adherence to medication schedules, and positive behaviour changes. The investigators will utilise the Calendar app to communicate via daily reminders with patients undergoing orthodontic treatment with fixed appliances and Class II intraoral elastics, and they will measure the improvement in the malocclusion. This will allow study of whether or not electronic reminders can significantly increase compliance. As more apps are developed, this communication method may have the potential to greatly impact the way orthodontists and patients interact outside of the office. If effective, these apps could become a cornerstone of the compliance efforts of many orthodontic practices. This would benefit both the orthodontist and the patient, as it would decrease time and money spent for both parties as well as reduce the overall sense of frustration felt during extended orthodontic treatment.
Interventions
BEHAVIORALReminders
Four reminders will be set on the patient's mobile phone's Calendar-type app, saying Don't forget to wear your elastics, at 08:00, 13:00, 17:00 and 22:00.
Sponsors
King's College Hospital NHS Trust
Guy's and St Thomas' NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
10 Years to 20 Years
Healthy volunteers
Yes
Inclusion criteria
* Full fixed appliances with intraoral class II elastics full-time * Wearing class II elastics for between 6 weeks & 3 months * Have smartphone with calendar-type app
Exclusion criteria
* Orthognathic surgery planned * Craniofacial disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in number of elastics used and collected by the participant | 6 weeks, 12 weeks | Participants from both arms will collect their used elastics in a plastic bag provided, which will be collected at each recall appointment and counted. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient's self-reported duration of time spent wearing intraoral elastics | 6 weeks and 12 weeks | Participants will fill out duration journals between appointments, on which they tick boxes to record how many hours a day they have worn their elastics |
| Change in participant's jaw relationship, measured on mm scale by difference in overbite, overjet and molar relationship | Baseline, 6 weeks, and 12 weeks | Clinicians will record these occlusal measurements at each appointment |
| Clinician-perceived level of compliance of the participant at each appointment, using discrete qualitative scale | Baseline, 6 weeks, and 12 weeks | Clinicians will record whether they think the patient has been highly, somewhat, or not at all compliant |
Countries
United Kingdom
Contacts
Primary ContactDirk Bister
Backup ContactJadbinder Seehra
Outcome results
None listed