Amoo-Achampong F, et al. - Authors sought to estimate plaque and bleeding in periodontal patients over time to determine patterns of patient response to oral hygiene instructions. Findings illustrated 3 patterns in response to oral hygiene instructions. Plaque and gingival bleeding indexes improved, worsened, or fluctuated over time in the periodontal patients. Statistically significant variations were noted only in the ethnic background. It was also observed that in terms of oral hygiene quality, white individuals more often than other ethnic groups fluctuated after instructions.