The Effect of Chairside Verbal Instructions Matched with Instagram Social Media on Oral Hygiene of Young Orthodontic Patients: A Randomized Clinical Trial

Featured Application The social media Instagram could represent a valid support for orthodontists in addition to verbal motivation of young orthodontic patients towards a correct oral hygiene. Objective: To investigate the effectiveness of Instagram in improving oral hygiene compliance and knowledge in young orthodontic patients compared to traditional chairside verbal instructions. Design: Single-center, parallel, randomized controlled trial. Setting: Section of Dentistry of University of Pavia. Participants: 40 patients having fixed appliances in both arches were recruited and randomly divided into an intervention (n = 20) and a control group (n = 20). Intervention: At a first appointment, both groups were given verbal instructions and motivated to oral hygiene. In addition, multimedia contents on Instagram were sent weekly to trial participants for six months. Main outcome measures: For all participants, the bleeding index (BI), modified gingival index (MGI), and plaque index (PI) were assessed at baseline (T0), after one (T1), three (T2), and six months (T3). A questionnaire was administered at the beginning (T0) and at the end of the study (T3) to assess participants' knowledge. Results: In both groups, BI, MGI, and PI significantly decreased (p < 0.05) at T1 (means control group: BI 0.26 +/- 0.22, MGI 0.77 +/- 0.36, PI 0.53 +/- 0.20; means test group: BI 0.24 +/- 0.22, MGI 0.65 +/- 0.46, PI 0.49 +/- 0.21) compared to baseline (means control group: BI 0.56 +/- 0.27, MGI 1.23 +/- 0.41, PI 0.87 +/- 0.23; means test group: BI 0.54 +/- 0.26, MGI 1.18 +/- 0.39, PI 0.93 +/- 0.20) but no significant differences in clinical measures were showed between T1, T2, and T3 (p > 0.05) (intragroup differences). Trial patients demonstrated significant improvements in knowledge with respect to controls comparing scores at T0 and T3 (p < 0.05) but despite this result in the test group clinical outcomes did not report significant intergroup differences at any time (p > 0.05). Conclusions: Presenting multimedia information through Instagram resulted in a significant improvement in knowledge. Therefore, this social media represents an aid to the standard verbal motivation performed by orthodontists towards young patients under an orthodontic treatment.