Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Dental public health

Does using mobile applications and social media-based interventions induce beneficial behavioral changes among orthodontic patients?



Systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials (CCTs). The protocol of the study was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019157298).

Data sources

Seven electronic databases (MEDLINE, Web of Science Core Collection, Unpublished Clinical Trials accessed through, Embase, LILACS, ProQuest Database, The Cochrane Library) were searched. Additionally, the reference lists of the included studies were hand searched.

Study selection

Clinical trials (RCT and CCT) that assessed the impact of the interventional use of mobile applications and social media among orthodontic patients were included. The review question was defined in PICO format as follows: population (P) = patients (no age restriction) undergoing orthodontic treatment using fixed, removable, or functional appliances, or patients in the retention phase that are wearing fixed or removable retainers; intervention (I) = mobile applications and social media-based interventions; comparison (C) = control group that did not receive any adjunctive intervention; outcome (O) = behavior changes in orthodontic patients after receipt of the intervention. Two authors independently conducted literature search from inception up to March 2021.

Data analysis

Social media-based interventions and mobile applications (or bespoke) were used in the form of reminders (WhatsApp reminders) and provision of information including YouTube videos and Instagram posts. Primary outcomes included adherence to wearing appliances or adjuncts, oral hygiene levels, oral health-related behaviors, periodontal outcomes, appointment attendance, knowledge, and related iatrogenic effects. Treatment-related experiences and patient-reported outcomes were assessed as secondary outcomes.


16 studies (14 RCTs and 2 CCTs) were included in the qualitative synthesis, of which only 7 studies were included in the quantitative synthesis (meta-analysis). Results from meta-analyses showed that the intervention was favored in relation to gingival index (GI) (number of studies = 4, standardized mean difference [SMD] = −0.81, 95% confidence interval [CI] = −1.35 to −0.28, P = 0.00, certainty of evidence = very low), plaque index (PI) (number of studies = 7, SMD = −0.91 [95% CI, −1.64 to −0.19], P = 0.01, certainty of evidence = very low), and bleeding index (BI) (number of studies = 4, SMD = −0.22 [95% CI, −0.50 to 0.05], P = 0.11, certainty of evidence = high). Sensitivity analysis was performed (including additional 3 studies for GI and 5 studies for PI), which also favored the intervention in relation to GI (number of studies = 7, SMD = −0.60 [95% CI, −1.01 to −0.18], P = 0.00, certainty of evidence = very low), and PI (number of studies = 12, SMD = −0.67 [95% CI, −1.14 to −0.19], P = 0.01, certainty of evidence = very low).


Limited evidence supports beneficial behavior change among orthodontic patients when using mobile applications or social media-based interventions.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout


  1. Fleming PS, Scott P, DiBiase AT. Compliance: getting the most from your orthodontic patients. Dent Update. 2007;34:565–66. 569-566, 572

    Article  PubMed  Google Scholar 

  2. Papadimitriou A, Kakali L, Pazera P, Doulis I, Kloukos D. Social media and orthodontic treatment from the patient’s perspective: a systematic review. Eur J Orthod. 2020;42:231–41.

    Article  PubMed  Google Scholar 

  3. Food and Drug Administration. Mobile medical applications: guidance for industry and food and drug administration staff.

  4. Tiffany B, Blasi P, Catz SL, McClure JB. Mobile apps for oral health promotion: content review and heuristic usability analysis. JMIR MHealth UHealth. 2018;6:e11432.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Maher CA, Lewis LK, Ferrar K, Marshall S, De Bourdeaudhuij I, Vandelanotte C. Are health behavior change interventions that use online social networks effective? A systematic review. J Med Internet Res. 2014;16:e40.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Al-Moghrabi D, Colonio Salazar FB, Johal A, Fleming PS. Factors influencing adherence to vacuum-formed retainer wear: a qualitative study. J Orthod. 2019;46:212–9.

    Article  PubMed  Google Scholar 

  7. El-Huni A, Colonio Salazar FB, Sharma PK, Fleming PS. Understanding factors influencing compliance with removable functional appliances: a qualitative study. Am J Orthod Dentofacial Orthop. 2019;155:173–81.

    Article  PubMed  Google Scholar 

  8. Villanti AC, Johnson AL, Ilakkuvan V, Jacobs MA, Graham AL, Rath JM. Social media use and access to digital technology in US young adults in 2016. J Med Internet Res. 2017;19:e196.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Al-Moghrabi D, Alkadhimi A, Tsichlaki A, Pandis N, Fleming PS. The influence of mobile applications and social media-based interventions in producing behavior change among orthodontic patients: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2022;161:338–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Rahma ElNaghy.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

ElNaghy, R., Al-Qawasmi, R. & Hasanin, M. Does using mobile applications and social media-based interventions induce beneficial behavioral changes among orthodontic patients?. Evid Based Dent 24, 26–27 (2023).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links