The effect of text message reminders on compliance with Twin Block appliances: A randomised controlled trial

Aims: The aim of this study was to evaluate whether text reminders influence patient compliance with Twin Block appliances. The null hypothesis was that there was no statistically significant differences in Twin Block compliance between those who receive text reminders and those that do not. Design: Single-blind parallel randomised controlled clinical trial. Setting: Health Service Executive (HSE) orthodontic outpatient clinic in Dublin, Ireland. Participants: A total of 59 patients aged 11-15 years with a 5a Index of Orthodontic Treatment Need (IOTN grade) starting treatment with Twin Block appliances. Methods: A computer-generated unstratified allocation sequence was used to randomise the participants into the control group (CG) or the text group (TG). Both groups were asked to wear their appliances full-time. In addition to the same verbal and written instruction received by the CG, the TG received text message reminders to wear their appliances every 3 days. The primary outcome measure was wear time reported by Theramon(& REG;) sensors embedded in the appliances. Data on wear time were uploaded from the Theramon(& REG;) sensors onto cloud software. Participants in both groups were asked to fill out wear diaries and submit these at each visit. Treating clinicians and the primary investigator were blinded to the allocation group. Participants were followed up for 4 months. Participants were not blinded to their treatment group. Results: In total, 29 participants were allocated to the CG and 30 to the TG. The data for 53 participants were analysed, 24 from the CG and 29 from the TG. The median hours/day of wear recorded using the Theramon(& REG;) sensors was 13.77 (interquartile range [IQR] = 10.19) for the CG and 17.72 (IQR = 5.62) for the TG. The difference in wear time recorded was not statistically significant (P = 0.16). Conclusion: The study concluded that text message reminders had no statistically significant influence on patient compliance with Twin Block appliances.