The majority of orthodontic patients undergo at least some of their treatment during their early teens (Wallis, 2012), and this be quite a challenging age for dental professionals.
In a study held at the University of Amsterdam, all participating orthodontists agreed that patient cooperation is vital for a successful course. In the same report, 24% of respondents stated puberty as one of the main reasons why patients do not fully comply with orthodontic treatment protocol (Bos et al, 2005).
The challenge ahead
Dental professionals who see young patients during their orthodontic treatment may need to try more effective ways of getting them to clean their teeth properly every day. A combination of verbal and visual instruction is one effective way to improve compliance in adolescents. In a study with orthodontic patients in their early teens, the group that was taught good oral hygiene with the use of an illustrated catalogue presented with reduced plaque index, gingival index and bleeding on probing scores (Ay et al, 2007).
Dentist-patient rapport and verbal praise is also helpful in ensuring patient compliance during orthodontic treatment (Ay et al, 2007). Certain behaviour-modification techniques, such as a rewards system, can help improve the oral hygiene scores of young patients too (Ritcher et al, 1998).
A reward programme
An idea for a rewards programme, for example, is a points-based scheme where oral hygiene is scored from one to 10 during each visit, with the scores added up towards a small prize every few months. In systems such as these, the sense of achievement that patients get from accumulating those points is much more important than the monetary value of the reward per se.
Giving young patients a bigger role in the decision-making process of their treatment can also motivate them to take more responsibility for their own oral health.
For example, dental professionals can suggest the use of an essential-oil mouthwash, which has been proven to reduce the amount of plaque and gingivitis in orthodontic patients (Tufecki et al, 2008). Of course, they need to be reminded that a mouth rinse is an addition to, and never a replacement for, tooth brushing and interdental cleaning.
The electric toothbrush
To cover one of the main aspects of the orthodontic oral care regimen electric toothbrushes can be introduced. While there may be insufficient evidence supporting the idea that electric toothbrushes are more effective than their manual counterparts (Kaklamanos and Kalfas, 2008), patients seem to prefer them (Muhler, 1969) and so are more likely to maintain good oral hygiene routines.
Another possible addition to an adolescent’s oral care routine is a Waterpik water flosser, which removes up to 3.67 times more plaque than traditional flossing alone, and reduces gum bleeding by up to 84.5% in orthodontic patients (Sharma et al, 2008). In a recent study conducted with adolescent orthodontic patients, 92% liked using the water flosser so much that they would use the instrument ‘every day’ or ‘frequently’ (Waterpick, [Accessed 2014]).
The right technique
Dental care professionals who are in regular contact with adolescent patients can employ certain motivational tools and techniques that should help improve their compliance scores.
And with alternative cleaning aids that bring efficacy and ease to their oral care regimen, adolescents and practitioners alike can look forward to better oral health in the course of orthodontic treatments.
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