Effects of motivational methods on oral hygiene of orthodontic patients: A systematic review and meta-analysis

OBJECTIVE: The aim of our study was to qualitatively and quantitatively synthesize the evidence regarding ways to improve motivation of oral hygiene among orthodontic patients with fixed appliances and identify the effects of motivational methods via comparing the oral hygiene condition before and after the motivations. METHODS: An electronic search was conducted in PubMed, Ovid, Embase, and the Crochrane Library for relevant random controlled trials (RCT) and clinical controlled trial (CCT) published before May 1(st), 2017 with manual search in addition. Search and selection of studies, quality assessment, data extraction and synthesis was completed by 2 reviewers independently. Plaque index (PI) and gingival index (GI) at 1, 3, 6-month were pooled with Review Manager 5.3. Bias of included studies was evaluated. RESULTS: In total, 12 studies fulfilled the inclusion criteria of this systematic review, of which, 5 were included in the meta-analysis. Motivational methods had statistically significant advantage regarding PI in the experimental group over control group at 1, 3, 6-month, while GI was significantly better controlled in the study group at 3, 6-month. The quality of included studies was moderate. CONCLUSION: It is worthy for orthodontists to put in additional efforts to motivate patients to maintain good oral hygiene throughout the entire treatment process.