An eight-month randomized controlled trial on the use of intra-oral cameras and text messages for gingivitis control among adults

Objective: To investigate the effects of using an intra-oral camera (IOC) during a dental hygiene consultation and mobile text messages (TM) between appointments on clinical, behavioural and psychological parameters of patients with gingivitis. Materials and methods: Patients were randomly assigned into four conditions: IOC, TM, IOC + TM and control, and examined at three assessment points over eight months (N = 142). Bleeding on marginal probing (BOMP), dental hygiene (brushing and flossing) and social cognitive determinants of behaviour change (outcome expectancies, action and volitional self-efficacy, intention, planning and action control) were evaluated in an examiner-blind controlled study. Mixed-effects modelling was employed to examine changes in study outcomes. Mediations by the psychological determinants were inspected for the effect on treatment groups in clinical parameters and behaviour. Results: Compared to the control group, all treatment conditions improved dental hygiene and revealed a significant decrease in BOMP from baseline to 4 months, maintained at 8 months; this was clinically relevant in the IOC + TM group, where individuals had more positive outcome expectancies as well as higher levels of action self-efficacy and intention from baseline to four months, maintained at eight months. Volitional self-efficacy was reinforced in all treatments. The psychological determinants did not prove to be the mechanisms responsible for these effects. Conclusions: A multiple-strategy benefit from using the IOC in consultation and TM between appointments improves clinical, behavioural and psychological parameters of periodontal health four months after treatment, maintained at eight months’ follow-up. Insights are provided for the efficacy of the images and text messages for oral hygiene changes.