Perception of oral hygiene during orthodontic treatment: an eye-tracking and cross-sectional study

The objective of this study was to analyze visual perception of patients undergoing orthodontic treatment with multi-bracket appliances (MBA), and examine differences in oral hygiene perception among adolescents, their guardians, and dental students. The lay person group included 56 participants (28 adolescents and guardians), while the expert group consisted of 30 dentistry students. Both groups evaluated randomized intraoral frontal photographs of adolescents with MBA, taken with or without a plaque disclosing agent. Using eye-tracking methods, eye movements were recorded during the evaluation. Significant differences in visual path length and oral hygiene evaluation were found. The expert group evaluated oral hygiene most accurately, with parents being stricter and adolescents more lenient. The expert group's visual path was significantly shorter than the lay person group's. Use of a plaque disclosing agent improved the accuracy of oral hygiene evaluation (p < 0.001). A correlation was observed between oral hygiene behavior and evaluation. In conclusion, dental students provided the most accurate oral hygiene evaluations. Parents were stricter, and adolescents were more lenient. Among adolescents, longer brushing time was weakly associated with more accurate evaluations, and plaque disclosing agents enhanced evaluation accuracy.