Efficacy of four motivational techniques for improving oral hygiene. One-year follow-up of a randomized controlled trial.

Purpose The aim of this randomized, examiner blinded, controlled study was to compare the efficacy of four different methods of motivation to oral hygiene (i) in reducing the full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS), (ii) in modifying the patient behaviour (iii) in the operating time required, and (iv) in the degree of patient satisfaction at one-year follow-up. Materials and Methods In a private practice, 100 subjects aged 18-75 years with at least 20 teeth/implants present and a FMPS ≥ 40%, were consecutively recruited. From baseline and up to one-year of follow-up, the subjects randomly underwent to four different motivational techniques of oral hygiene: standard instructions of oral hygiene (SIOH), reading a pamphlet (P), watching a video (V), brief motivational interviewing (BMI). The variables considered were the reduction in FMPS, reduction in FMBS, frequency of daily tooth brushing, frequency of daily flossing, the motivational time, degree of satisfaction, perception of oral health of patients (by means of a questionnaire), and number of teeth lost for each method. A single operator carried out all motivational meetings and/or professional oral hygiene at baseline and 1, 3, 6, 12 months. Another operator, blinded to the used methods, recorded variables at baseline, 6 and 12 months. Results At 12-month follow-up, there were no significant differences between the tested methods in FMPS (the reduction in FMPS was 16.7 for SIOH, 18.8 for V, 20.1 for P, and 27.7 for BMI; P=0.0730), FMBS (the reduction in FMBS was 3.0 for SIOH, 2.3 for V, 4.2 for P, and 2.9 for BMI; P=0.5776), degree of patient satisfaction (P=0.2410), improvement in perception of oral health (P=0.2067), frequency of daily flossing (P=0.2500), and number of tooth loss (P=0.0651). The frequency of daily tooth brushing significantly increased for the BMI as compared to SIOH and V (the difference between BMI and SIOH was 0.6; 95%CI from 0.2 to 1.0, and the difference between BMI and V was 0.5 95%CI from 0.1 to 0.9; P=0.0011). The total time required for motivation was significantly greater for the BMI as compared to all other techniques (P<0.0001). Conclusions All tested methods improved FMPS and FMBS and were appreciated by all subjects. The change in patient behavior was more pronounced in the BMI, but its requested time was greater compared to the other techniques, nevertheless it was compatible with a session of professional oral hygiene of one-hour duration.