The Effect of Mobile Text Messages and a Novel Floss Holder on Gingival Health: A randomized control trial.

Purpose: The purpose of this study was to evaluate the effects of using mobile text messages and a novel floss holder as compared to finger flossing or the novel floss holder alone, on the psychological, behavioral, and clinical parameters of patients with gingivitis.Methods: A total 165 adults were assessed for eligibility and 144 met the criteria for randomization into three groups: Finger Floss (FF, n=43), Novel Floss Holder (NFH, n= 40), and Novel Floss Holder plus Text Messages (NFH+TM, n= 61) following a dental hygiene consultation appointment. Gingival bleeding points were measured on probing (BOMP) at baseline and four months later by a calibrated dental hygienist, blinded to the experimental groups. Participants also self-reported their oral hygiene behaviors, and indicated psychological determinants of behavior change prior to the dental hygiene consultation and at four months. Descriptive statistics and repeated measures analysis of variance (ANOVA) were used to compare groups over time.Results: Two subjects dropped out of the study making the total number of participants 142. At the four month follow-up, the NFH group and the NFH+TM groups demonstrated significantly higher levels of self-reported flossing, action self-efficacy, intention, action planning, and action control. The NFH+TM group showed lower levels of bleeding and higher levels of oral hygiene and recovery self-efficacy than the other groups, in addition to higher levels of maintenance self-efficacy as compared to the FF group.Conclusions: The use of a novel floss holder, NFH, was shown to improve the behavioral and psychological determinants of periodontal health four months after introduction of the device. However the clinical measures of BOMP only improved significantly when used in conjunction with text messages (NFH+TM). The use of a consciousness awareness technique,TMs, in combination with a novel device, may help patients to reach therapeutic objectives and contribute to the management of periodontal pathologies such as gingivitis.

Self-regulation in oral hygiene behaviours in adults with gingivitis: The mediating role of coping planning and action control.

AIM: This study investigates the joint role of volitional predictors of oral hygiene behaviours of flossing and brushing in adults with gingivitis, framed by the Health Action Process Approach model (HAPA). MATERIALS AND METHODS: In a longitudinal online survey, 201 participants aged 18-75, of which 56.7% were women, completed assessments at baseline(T1), 2 weeks(T2) and 4 months(T3). Oral hygiene behaviours(OH) (brushing and flossing) and social cognitive determinants of behaviour in the HAPA: action and maintenance self-efficacy(ASE & MSE), intention(INT), coping planning(CP) and action control(AC) were evaluated. Structural equation modelling was used to test a series of three nested models. In Model 1, action self-efficacy would determine MSE and INT, and INT would determine OH; in Model 2, INT would determine both CP and AC and the two OH behaviours; and in Model 3, CP and AC would be sequential mediators between INT and OH. RESULTS: Model 3, predicting a mediating process from intention to behaviour via coping planning and action control, showed the best fit according to the fit indices and explained more of the variance in dental hygiene. The mediating role of coping planning and action control between intention and oral hygiene behaviours was thus confirmed. Importantly, coping planning did not mediate between intention and oral hygiene behaviours, which means that oral hygiene intention influences action control through coping planning, and both sequentially mediate this influence on behaviour. CONCLUSIONS: For individuals who are not yet following the recommendations for specific oral hygiene behaviours, coping planning and action control represent psychological mechanisms by which intentions are put into practice.

An eight-month randomized controlled trial on the use of intra-oral cameras and text messages for gingivitis control among adults.

OBJECTIVE: To investigate the effects of using an intra-oral camera (IOC) during a dental hygiene consultation and mobile text messages (TM) between appointments on clinical, behavioural and psychological parameters of patients with gingivitis. MATERIALS AND METHODS: Patients were randomly assigned into four conditions: IOC, TM, IOC + TM and control, and examined at three assessment points over eight months (N = 142). Bleeding on marginal probing (BOMP), dental hygiene (brushing and flossing) and social cognitive determinants of behaviour change (outcome expectancies, action and volitional self-efficacy, intention, planning and action control) were evaluated in an examiner-blind controlled study. Mixed-effects modelling was employed to examine changes in study outcomes. Mediations by the psychological determinants were inspected for the effect on treatment groups in clinical parameters and behaviour. RESULTS: Compared to the control group, all treatment conditions improved dental hygiene and revealed a significant decrease in BOMP from baseline to 4 months, maintained at 8 months; this was clinically relevant in the IOC + TM group, where individuals had more positive outcome expectancies as well as higher levels of action self-efficacy and intention from baseline to four months, maintained at eight months. Volitional self-efficacy was reinforced in all treatments. The psychological determinants did not prove to be the mechanisms responsible for these effects. CONCLUSIONS: A multiple-strategy benefit from using the IOC in consultation and TM between appointments improves clinical, behavioural and psychological parameters of periodontal health four months after treatment, maintained at eight months' follow-up. Insights are provided for the efficacy of the images and text messages for oral hygiene changes.

Psychological, behavioral, and clinical effects of intra-oral camera: a randomized control trial on adults with gingivitis.

OBJECTIVES: To evaluate the effects of using an intra-oral camera (IOC) during supportive periodontal therapy (SPT), on the psychological, behavioral, and clinical parameters of patients with gingivitis, outlined by evidence and a theory-based framework. METHODS: A group of 78 adult patients with gingivitis receiving an SPT was randomized into two groups: IOC and control. Bleeding on Marginal Probing (BOMP), self-reported dental hygiene behaviors, and psychological determinants of behavior change (outcome expectancies, self-efficacy, and planning) and IOC opinion were evaluated 1 week before or during the appointment and 4 months later. Repeated-measures anova was used to compare groups over time. RESULTS: Almost all the patients brushed their teeth daily, while 78% either never or hardly ever used dental floss. The IOC group showed significant improvements in BOMP index (P < 0.001), self-reported flossing (P < 0.05), and self-efficacy (P < 0.05) compared to the control group. CONCLUSIONS: The use of IOC significantly improves clinical, behavioral, and psychological determinants of periodontal health 4 months after treatment.