Effectiveness of the Brush DJ app in improving oral hygiene among patients with fixed orthodontic appliances: a randomized controlled trial

Maintaining oral hygiene during fixed orthodontic treatment is challenging, and poor hygiene can result in complications such as gingivitis, periodontitis, and enamel demineralization. With digital health technologies becoming more integrated into patient care, mobile applications provide an excellent way to reinforce oral hygiene instructions and enhance compliance. Therefore, this study aimed to evaluate the effectiveness of a mobile-based oral hygiene application in improving oral hygiene status among patients with fixed orthodontic appliances. In this parallel Randomized Controlled Trial, 36 orthodontic patients were randomly assigned using computer-generated randomization and assessed at baseline (T0), 4 weeks (T1), and 8 weeks (T2). The intervention group (n = 18) used the Brush DJ app along with usual care, while controls (n = 18) received usual care only. Outcomes included Plaque Index (PI), Gingival Index(GI), and oral hygiene behavior via questionnaire. This trial found that study group's PI was significantly lower than controls at 4 weeks (1.16 ± 0.28 vs. 1.58 ± 0.34, p < 0.001) and 8 weeks (1.33 ± 0.29 vs. 1.70 ± 0.45, p = 0.007) with significant intragroup improvements over time. GI was lower in the study group at 4 weeks (p = 0.011), but not at 8 weeks (p = 0.068) and concluded that mobile application alongside traditional oral hygiene instructions enhances compliance, improves oral health outcomes, and supports orthodontic treatment success.Trial registration: This trial was registered with the Clinical Trials Registry India (CTRI) on 13 August 2021 (Registration No. CTRI/2021/08/035641).