A New Digital Communication Tool Between Dentist and Orthodontist to Improve Dental Prevention

Condition(s) studied

Investigational drug(s) / intervention(s)

There is no intervention: Observal Study.There is no intervention

Study summary

Dentists and orthodontists of the oral medicine department of Reims University Hospital noted that many children presented white spots around orthodontic brackets, or decays at the end of their multi-brackets orthodontic treatment. These defects required dental cares and sometimes led to dental avulsions. These situations highlighted a poor oral hygiene of children (poorly done or insufficient dental brushing), a lack of oral prevention of their dentist and/or orthodontist, or even a lack of communication between these two practitioners.

The objective of this study is to evaluate if a regular prevention and a specific communication between dentist and orthodontists could reduce the individual caries-risk of patients with multi-brackets orthodontic treatment. During all the orthodontic treatment, a semi-annual oral prevention consultation will be established for each patient, and a digital communication tool will be made available to dentists and orthodontists to facilitate their exchanges.

The study population consists of children under 18 years-old when laying multi-brackets orthodontic treatment.

The study population consists of children aged 8 to 18 years-old (at the start of treatment) treated with multi-brackets orthodontic treatment. The study population is divided in two groups: (i) a control group corresponding to children not benefiting from regular oral preventive follow up monitoring and completing their orthodontic treatment during the year in 2024; (ii) a study group composed of children starting their orthodontic treatment during the year in 2024 and benefiting from regular oral prevention every 6 months, up to four years.

Several parameters will be evaluated from patient medical records: the caries index, the ICDAS score, the plaque index, the oral hygiene and food habits. Concerning the study group, a new digital communication tool will be made available to the dentist and the orthodontist to monitor the oral hygiene of patients. An evaluation of the oral hygiene will be done every 6 months.

The expected outcomes of this study concern the interest of (i) a bi-annual prevention consultation to reduce caries risk, (ii) a regular communication between practitioners to adjust the orthodontic treatment according to the individual caries-risk.

The expected hypothesis is to decrease the patient's caries and plaque indexes in the study group.

Eligibility

Primary outcome measure(s)

• Measure of DMFT index — every 6 months, up to 4 years
  Number of Decayed, Missing due to caries, and Filled Teeth
• Measure of plaque index (Silness and Loe) — every 6 months, up to 4 years
  * Score 0 : absence of microbial plaque * Score 1 : film of bacterial plaque invisible to the naked eye; but thin film of microbial plaque along the free gingival margin collected with a probe * Score 2 : moderate accumulation with plaque in the sulcus visible to naked eye * Score 3 : large amount of plaque visible in sulcus or pocket along the free gingiva margin up to 2mm thick.
• Modified Orthodontic Plaque index (MOP) — every 6 months, up to 4 years
  * Score 0 : no plaque. * Score 1 : accumulation of mesial and/or distal plaque at the base of the attachment. * Score 2 : accumulation of mesial, distal, incisal and/or cervical plaque at the base of the attachment. * Score 3 : continuous plaque accumulation from the marginal gingiva to the base of the attachment. * Score 4 : complete coverage by the plaque.
• Measure of ICDAS score — every 6 months, up to 4 years
  * 0 No evidence of caries * 1 Initial caries * 2 Distinct visual change in enamel * 3 Localised enamel breakdown due to caries with no visible dentine * 4 Underlying dark shadow from dentine * 5 Distinct cavity with visible dentine * 6 Extensive distinct cavity with visible dentine
• Socio-Professional Category — Day 1
  * Farmers, * artisans, * traders and business leaders, * executives and higher intellectual professions, * intermediate professions, * employees, * workers

Trial sites (1)

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