Self-monitoring to improve home-based oral hygiene in seniors

Introduction: In order to achieve an optimal brushing result when performing self-responsible home-based oral hygiene, patients should be able to self-monitor both their brushing process and the cleaning result. This pilot study conducted in cross-over design aimed to determine if an app or an abacus can aid patients in implementing the "CIOTIPlus" tooth brushing system and technique when performing self-responsible home-based oral hygiene. Methods: Sixteen participants (8 female, 8 male; average age: 72.6 ± 4.2 years) were included in the study. The study was divided into 3 phases. In each phase, a different tool (self-developed app or "CIOTIPlus-Abacus") was used to support self-monitor home-based oral hygiene. In the baselinel examination (t0), in addition to the general anamnesis, the DMF-T/S and PSI, QHI and mAPI were recorded. The participants recorded their home-based oral hygiene for 3 weeks by noting the cleaned tooth surfaces/areas in each phase. In phase 1 (t1), the documentation was performed solely by using the app. In phase 2 (t2), the documentation ensued through the use of the app as well, but in contrast to t1, more functions were accessible on the app. In phase 3 (t3), the daily home-based oral hygiene was recorded using an abacus ("CIOTIPlus-Abacus"). The participants were also asked to fill out a questionnaire at t0, t2 and t3. Results: In the basic examination (t0), the participants showed an average QHIt0 of 2.1 ± 0.7 and an average mAPIt0 of 3.5 ± 0.6. At t1, the subjects showed significantly lower plaque-index values (PI values) in the area of the smooth and proximal surfaces (QHIt1 1.6 ± 0.6; p = 0.004; mAPIt1 2.9 ± 0.7; p = 0.003). At time t2, compared to t0 and t1, the average PI values were again significantly lower in the area of both the smooth (QHIt2 0.8 ± 0.4; p 0.0001) and proximal surfaces (mAPIt2 1.7 ± 0.5; p 0.0001). Fourteen participants (7 female, 7 male) were included in phase 3. The PI values in the area of the smooth and proximal surfaces at time t3b were also significantly lower in comparison to both t0 and t1. At time t3b, the PI value in the area of the smooth surfaces did not differ significantly compared to t2 (QHIt2–QHIt3b; p = 0.147), but the PI value in the area of the proximal surfaces was significantly lower (mAPIt2–mAPIt3b; p = 0.024). Conclusion: The results of this pilot study show that an app or an abacus are suitable tools for supporting patients to self-monitor their home-based oral hygiene, which could lead to significantly improved oral health. Keywords: CIOTIPlus-Abacus, CIOTIPlus-App, self-monitoring, self-responsible home-based oral hygiene