Effectiveness of Personalized Digital Oral Health Intervention in Patients With Fixed Orthodontic Appliances. (PDHOI)

October 31, 2026 updated by: Lara Zozan Jamil Miran, Kurdistan Higher Council of Medical Specialties

Effectiveness of Personalized Digital Oral Health Intervention in Patients With Fixed Orthodontic Appliances: a Randomized Controlled Trial

This study will evaluate whether personalized digital oral-health education delivered through WhatsApp messages can improve oral hygiene in patients aged 16-25 years who wear fixed orthodontic appliances (braces). A total of 66 participants will be assigned to two groups. The intervention group will receive weekly digital oral-health messages for 12 weeks, while the control group will receive conventional verbal oral-hygiene instructions. Both groups will receive the same antibacterial mouthwash. Oral hygiene will be assessed at the beginning of the study and after 12 weeks by measuring plaque and gingival health using the Plaque Index and Gingival Index. The findings will help determine whether digital education can support conventional oral-hygiene instructions for patients undergoing orthodontic treatment.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This randomized controlled trial will evaluate the effectiveness of a personalized digital oral-health intervention in patients aged 16-25 years undergoing treatment with fixed orthodontic appliances.

A total of 66 eligible participants will be planned for enrollment and allocation into two groups in a 1:1 ratio, with 33 participants in each group.

The intervention group will receive weekly oral-health educational and motivational messages through WhatsApp over 12 weeks. The messages will address oral-hygiene practices during orthodontic treatment, including toothbrushing around fixed appliances, interdental cleaning, plaque control, gingival health, dietary habits, prevention of white spot lesions, and maintenance of oral hygiene.

The control group will receive conventional verbal oral-hygiene instructions. Both groups will receive the same alcohol-free antibacterial mouthwash to maintain consistency in this aspect of oral-hygiene care.

Clinical assessments will be conducted at baseline and after 12 weeks. Oral hygiene outcomes will be assessed using the Plaque Index and Gingival Index. The changes in these indices between the two assessment time points will be compared between the intervention and control groups.

The study is planned to recruit participants from dental centers in Erbil, Kurdistan Region, Iraq. Participation will be voluntary, and informed consent will be obtained before enrollment. For participants younger than 18 years, parental or guardian consent and participant assent will be obtained as applicable.

The findings are expected to provide evidence on whether digital oral-health education can support conventional oral-hygiene instructions for patients receiving fixed orthodontic treatment.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
66

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

16 years to 25 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

IInclusion Criteria:

Patients aged 16-25 years.

Patients wearing fixed orthodontic appliances on both the maxillary and mandibular arches.

Patients who agree to participate in the study.

Exclusion Criteria:

Patients wearing fixed orthodontic appliances on only one arch (maxillary or mandibular).

Patients who do not meet the inclusion criteria.

Patients who decline to participate.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Personalized Digital Oral Health Intervention

Participants will receive conventional verbal oral-hygiene instructions and the same study-provided antibacterial mouthwash as the control group. In addition, participants will receive weekly personalized digital oral-health messages through WhatsApp for 12 weeks. The messages will provide oral-hygiene education, motivation, and practical instructions for maintaining oral hygiene during fixed orthodontic treatment.
Behavioral: Personalized Digital Oral Health Education via WhatsApp

A 12-week digital oral-health education intervention delivered through WhatsApp to patients undergoing fixed orthodontic treatment. Participants receive one oral-health message per week covering oral hygiene awareness, motivation, and practical instructions for maintaining oral hygiene around orthodontic appliances. Topics include toothbrushing techniques, interdental cleaning, gingival health, plaque control, dietary advice, prevention of white spot lesions, and orthodontic appliance care. The intervention is provided in addition to conventional verbal oral-hygiene instructions and the study-provided antibacterial mouthwash.
Active Comparator: Standard Oral-Hygiene Instruction Group

Participants will receive conventional verbal oral-hygiene instructions and the same study-provided antibacterial mouthwash as the experimental group. They will not receive additional oral-health messages through WhatsApp during the 12-week study period.
Behavioral: Standard Oral-Hygiene Instructions

Conventional verbal oral-hygiene instructions provided to participants in the control group. Participants do not receive additional oral-health messages through WhatsApp during the 12-week study period.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Plaque Index (PI) from Baseline to 12 Weeks
Time Frame: Baseline and 12 weeks after the start of the intervention.

Plaque will be assessed using the Silness and Löe Plaque Index. Scores range from 0 to 3, with higher scores indicating greater plaque accumulation and poorer oral hygiene. The change in score will be assessed between baseline and 12 weeks.
Baseline and 12 weeks after the start of the intervention.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Change in Gingival Index (GI) from Baseline to 12 Weeks
Time Frame: Baseline and 12 weeks after the start of the intervention.

Gingival inflammation will be assessed using the Löe and Silness Gingival Index. Scores range from 0 to 3, with higher scores indicating greater gingival inflammation and poorer gingival health. The change in score will be assessed between baseline and 12 weeks.
Baseline and 12 weeks after the start of the intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Kurdistan Higher Council of Medical Specialties

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: lara Zozan MIran, BDS, Kurdistan Higher Council of Medical Specialtie

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 20, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 20, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 20, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 27, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 27, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 2, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 3, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 31, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 1246

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

The decision regarding sharing individual participant data (IPD) has not yet been made. Any future decision will consider participant confidentiality, data privacy, ethical requirements, and applicable institutional policies.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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