The Effectiveness of an Oral Hygiene App: A Clinical Trial

Abstract

Objectives: To determine the effectiveness of an App-based oral health promotion initiative compared to a conventional oral health promotion education initiative in the performance of tooth brushing, oral hygiene and gingival health among preschool children. Methods: A prospective single-blind randomized controlled clinical trial was conducted over a 6-month period. Preschool children (282) were randomized to receive an App based intervention (test group) or a conventional intervention (control group). Performance in tooth bushing was assessed on a standardised 13-step assessment and brushing time was recorded. Oral hygiene status was assessed by the Silness-Löe Plaque Index (PI) and gingival health was assessed by the Löe-Silness Gingival Index (GI). Assessments were carried out pre-intervention and at 3-month and 6-month post-intervention. Inter-group assessment of changes in outcome parameters were determined over time. Intra-group assessment of at various time points were conducted and mean changes of outcome parameters over the trial period between groups were determined. Results: The response rate to the trial was 82.7% (246/282). Inter-group comparisons identified significant improvements in tooth brushing performance (both p<0.001), time spent tooth brushing (both p<0.001), PI scores (both p<0.001) and GI scores (both p<0.001). Intra-group comparisons identified greater tooth brushing performance and time spent brushing among the test group at 3-month (both p<0.01) and 6-month (both p<0.001). Furthermore, over the trial period, the mean change in tooth brushing performance and time spent tooth brushing were significantly greater among the test group (both p<0.01). At 6-month PI scores were lower among the test group (p<0.05), and the mean change in PI scores over the 6-month period was greater among the test group (p<0.01). No significant intra group difference in GI scores were apparent at any time point (p>0.05); however a greater mean change in GI scores over the trial period occurred among test group (p<0.001). Conclusions: An App based oral health promotion initiative was more effective than a conventional oral health education initiative in promoting performance of tooth brushing, as well as improving oral hygiene and gingival health among preschool children.