Seventy – eight patients were selected at the beginning, requiring fixed orthodontic

treatment. They divided all the participants in three groups, twenty – six in each. To do
that they used a random sampling technique.
At the end, only 62 patients were available to do the first baseline and that’s because
some patients didn’t turn up for the treatment and others had their treatment plan
changed later. So, at the end, there were 21 participants on group 1, 23 on group 2
and 18 patients on group 3.

There were different things to keep in mind for the Inclusion in this study. They look
for patients in the age between 12 and 18 years, but also they had to have full
permanent dentition. Also it was important for the study that there wasn’t active
periodontal disease or dental caries.
On the other hand, all patients that were medically, mentally or physically
compromised were excluded from the study, as well as the patients that had cleft
palate, because their oral hygiene could be compromised.

So on the first group, they tried to motivate the patients through conventional plaque
control measures. They taught the patients the importance of the removal of the
plaque and how to remove it by using the horizontal scrubbing technique.
This technique consists in moving the brush back and forth on the teeth in scrubbing
motion. It’s one of the most commonly used techniques, but normally is not
recommended because it’s very abrasive and can cause gingival recession.

On group two, they tried to motivate the patients by using chair side motivational
techniques. For this they used an indicator called Bromocresol green. It works by
changing it’s color when there’s a drop on the pH. So they got a plaque sample from
their mouths and using a drop of this indicator.
They did it twice, the first time in normal plaque and the second after a glucose rinse
for 1 minute by the individual, where the Green turned into yellow. This showed them
that when they had an ingest of sugar, the pH from the mouth drops, and that’s when
the acids initiate demineralization, leading to cavity formation and ending in a
irritation of the gingival tissue, causing gingivitis.
As in group one, they also explained the conventional plaque control measures and
how to remove it.

On group three, patients were motivated by showing them the bacteria in their own
plaque under a phase contrast microscope in a magnification of 400X. This plaque was
collected from the interproximal areas of their mouth or from the gingival crevice.
They prepared the plaque by adding some drops of physiologic saline and removing
the excess.
This and a prerecorded video of the plaque bacteria was shown to the patients.
As well as in the other groups, a demonstrations of a horizontal scrubbing method was
shown