***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To test the effectiveness of different systems of reminding patients about their appointments in order to reduce the rate of failed attendance . The expense in implementing a reminder system for patients was also estimated . Design : A clinical study in a single-h and ed dental practice .Subjects : Patients were reminded about their appointment using either postal , manual telephone or automated telephone reminders ( or all three combined ) . A control group received no reminders .  500 patient attendances were recorded in each group . Results : Patients failed to attend  for 130 of the 2500 appointments considered in the study . There was a significant reduction in the failed attendance rate from 9.4 % ( with no reminder ) to a minimum of 3 % when a reminder was given to the patient before the appointment . However , there was no significant difference among the four reminder test groups , indicating that the form of the reminder made no difference to the failure rate . Conclusions : Reminding patients using postal or manual telephone techniques is effective at improving attendance . All of the reminder methods , telephone and postal , provided net cost savings rather than additional Background Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients ’ compliance over a period of 66 days . The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30–40 days . Methods Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department , Gaslini Hospital , Genova , between July and October 2014 were r and omly assigned to one of three trial arms . Before the bonding , all patients underwent a session of oral hygiene aim ed at obtaining an plaque index of “ zero . ” At the following orthodontic appointment , the plaque index was calculated for each patient in order to assess oral hygiene compliance . The first group served as control and did not receive any post-procedure communication , the second group received a structured text message giving reassurance , and the third group received a structured telephone call . Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study . ( The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014 , and it is not registered in the trial ’s register . ) Results Thirty patients were r and omly assigned to the control group , 28 participants to the text message group , and 26 to the telephone group . Participants who received a post-treatment communication  reported higher level of oral hygiene compliance than participants in the control group . The plaque index was 0.3 ( interquartile range ( Iqr ) , 0.60 ) and 0.75 ( Iqr , 1.30 ) , respectively , with a significant difference ( P = 0.0205 ) . Conclusions A follow-up procedure after orthodontic treatment may be an effective tool to increase oral hygiene compliance also over a short period OBJECTIVE To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances . MATERIAL S AND METHODS Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were r and omly divided into two groups of 40 .  Plaque index ( PI ) , gingival index ( GI ) , white spots ( WS ) , and caries presence were recorded in all patients , and they were instructed regarding domestic oral hygiene maintenance on the day of braces application ( t0 ) and every 3 months ( t1 , t2 , t3 , t4 ) during the first year of treatment . Study group ( SG ) patients were enrolled in a WhatsApp chat room-based competition and instructed to share monthly with the other participants two self-photographs ( selfies ) showing their oral hygiene status . RESULTS SG patient participation in the chat room was regular and active throughout the observation period . At t2 , t3 , and t4 , SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries , compared with the control group . CONCLUSION Integration of new " social " technologies in a st and ard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and in improving their oral health status during orthodontic multibracket treatment OBJECTIVE To determine if text message reminders regarding oral hygiene compliance have an influence on the level of compliance within an orthodontic population . MATERIAL S AND METHODS In this prospect i ve , r and omized , controlled clinical trial , 42 orthodontic patients were assigned to a text message or control group . Parents of patients assigned to the text message group received a reminder text message one weekday each week .  Oral hygiene compliance was measured using bleeding index ( BI ) , modified gingival index ( MGI ) , and plaque index ( PI ) , and visual examination of white spot lesion ( WSL ) development at baseline ( T0 ) , two appointments after baseline ( T1 ) , and four appointments after baseline ( T2 ) . RESULTS BI , MGI , and PI scores were significantly lower in the text message group than in the control group at T2 . CONCLUSION A text message reminder system is effective for improving oral hygiene compliance in orthodontic patients Background Telephone or text-message reminders have been shown to significantly reduce the rate of missed appointments in different medical setting s. Since text-messaging is less re source -dem and ing , we tested the hypothesis that text-message reminders would be as effective as telephone reminders in an academic primary care clinic . Methods A r and omized controlled non-inferiority trial was conducted in the academic primary care division of the Geneva University Hospitals between November 2010 and April 2011 . Patients registered for an appointment at the clinic , and for whom a cell phone number was available , were r and omly selected to receive a text-message or a telephone call reminder 24 hours before the planned appointment . Patients were included each time they had an appointment . The main outcome was the rate of unexplained missed appointments . Appointments were not missed if they were cancelled or re-scheduled before or independently from the intervention . We defined non-inferiority as a difference below 2 % in the rate of missed appointments and powered the study accordingly . A satisfaction survey was conducted among a r and om sample of 900 patients ( response rate 41 % ) . Results 6450 patients were included , 3285 in the text-message group and 3165 in the telephone group . The rate of missed appointments was similar in the text-message group ( 11.7 % , 95 % CI : 10.6 - 12.8 ) and in the telephone group ( 10.2 % , 95 % CI : 9.2 - 11.3 p = 0.07 ) . However , only text message reminders were cost-effective . No patient reported any disturbance by any type of reminder in the satisfaction survey . Three quarters of surveyed patients recommended its regular implementation in the clinic . Conclusions Text-message reminders are equivalent to telephone reminders in reducing the proportion of missed appointments in an academic primary care clinic and are more cost-effective . Both types of reminders are well accepted by patients PURPOSE This prospect i ve longitudinal study compared the patterns of oral health behaviors between low and high socioeconomic status ( SES ) families participating in the Iowa Fluoride Study for a period of 9 years . METHODS Information on oral health behaviors , including consumption of juices/juice drinks , soda pop , and powder-based drinks , dental visits , and tooth-brushing frequency , was collected longitudinally at periodic intervals from 6 to 108 months of age . Dental exams were conducted at 5 and 9 years of age . Classification of low socioeconomic status ( SES ; n=70 ) and high-SES ( n= 128 ) children was based on baseline family income and mothers ' education levels , with middle SES excluded . RESULTS Low SES children consistently had significantly greater consumption of soda pop and powder-based beverages .  There were , however , virtually no differences at any time point between groups in : ( 1 ) tooth-brushing frequency ; ( 2 ) use of dentifrice ; or ( 3 ) fluoride concentration in drinking water . Furthermore , the mean number of decayed and filled surfaces was significantly higher in the low-SES group . CONCLUSIONS Results suggest that beverage consumption patterns are a key difference between high- and low-socioeconomic status families and could in part explain differences in caries experience between subjects of different SES . Modification of the pattern of soda pop and powder-based beverage consumption in the low-SES groups might reduce their caries experience OBJECTIVE To investigate the effects on plaque index ( PI ) scores of manual or electric toothbrush with or without repeated oral hygiene instructions ( OHI ) and motivation on patients wearing fixed orthodontic appliances . MATERIAL S AND METHODS One month after the orthodontic fixed appliance bonding on both arches , 60 patients were r and omly assigned to four groups ; groups E1 ( n = 15 ) and E2 ( n = 15 ) received a powered rotating-oscillating toothbrush , and groups M1 ( n = 15 ) and M2 ( n = 15 ) received a manual toothbrush . Groups E1 and M1 received OHI and motivation at baseline ( T0 ) and after 4 , 8 , 12 , 16 , and 20 weeks ( T4 , T8 , T12 , T16 , and T20 , respectively ) by a Registered Dental Hygienist ; groups E2 and M2 received OHI and motivation only at baseline . At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI . RESULTS In all groups the PI score decreased significantly over time , and there were differences among groups at T8 , T12 , T16 , and T20 . At T8 , PI scores of group E1 were lower than those of group E2 , and at T12 , T16 , and T20 , PI scores of groups M1 and E1 were lower compared to those of groups M2 and E2 . A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant , independently from the use of manual or electric toothbrush . CONCLUSIONS The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients , independent of the type of toothbrush used Background The ' Hawthorne Effect ' may be an important factor affecting the generalisability of clinical research to routine practice , but has been little studied . Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge , no attempt has been made to quantify them . Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia . Methods Participants in a dementia trial were r and omised to intensive follow-up ( with comprehensive assessment visits at baseline and two , four and six months post r and omisation ) or minimal follow-up ( with an abbreviated assessment at baseline and a full assessment at six months ) . Our primary outcomes were cognitive functioning ( ADAS-Cog ) and participant and carer-rated quality of life ( QOL-AD ) . Results We recruited 176 participants , mainly through general practice s. The main analysis was based on Intention to treat ( ITT ) , with available data . In the ANCOVA model with baseline score as a co-variate , follow-up group had a significant effect on outcome at six months on the ADAS-Cog score ( n = 140 ; mean difference = -2.018 ; 95%CI -3.914 , -0.121 ; p = 0.037 favouring the intensive follow-up group ) , and on participant-rated quality of life score ( n = 142 ; mean difference = -1.382 ; 95%CI -2.642 , -0.122 ; p = 0.032 favouring minimal follow-up group ) . There was no significant difference on carer quality of life . Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia result ed in a better outcome than minimal follow-up , as measured by their cognitive functioning . Trial registration Current controlled trials : IS RCT INTRODUCTION Fixed orthodontic treatment is frequently associated with increased plaque accumulation leading to gingivitis and white spot lesions ( WSLs ) . AIM This study evaluated the role of text message reminder on oral hygiene of orthodontic patients . MATERIAL S AND METHODS A total of 60 patients under fixed orthodontic treatment were r and omly divided into two equal groups as control group and study ( text message ) group . Text message group received reminders about oral hygiene , while the control group did not receive any messages .  Oral hygiene of both the groups was evaluated at baseline , 2 , and 3 months using plaque indices ( PIs ) along with WSL status . Data were statistically analyzed using Statistical Package for the Social Sciences ( SPSS ) statistical software , version 19 , with chi-square test and t-test . RESULTS At the baseline , plaque score was higher in the study group over control group ( p > 0.038 ) , whereas it was decreased after 3 months in the test group ( p > 0.001 ) . For WSL , there was no significant difference at baseline , but it was significantly lower in study group ( p > 0.003 ) . CONCLUSION Oral hygiene status improved with text message reminder Objectives To evaluate the effect of issuing a patient reminder plus a confirmation slip on the attendance of orthodontic new patients . 
    Output:
    
There is moderate-to-high quality of evidence that reminders have a positive effect on OH and adherence to appointments in orthodontic patients .
These effects were demonstrated in the short- and long-term .