The Effectiveness of Educational Mobile Messages for Assisting in the Prevention of Early Childhood Caries: Protocol for a Randomized Controlled Trial

WhatsApp-based intervention in urban Colombia to support the prevention of arboviral diseases: a feasibility study

Arboviral diseases remain a significant health concern worldwide, with over half the world's population at risk for dengue alone. Without a vaccine or targeted treatment, the most effective strategy of prevention is vector management with community involvement. mHealth interventions, like WhatsApp, offer promising results for engaging communities and promoting healthier behaviors. This study explores the feasibility of integrating WhatsApp in vector control activities to improve arbovirus prevention in Colombia. A mixed-methods approach was employed to assess the WhatsApp-based intervention. WhatsApp messages were sent to 45 community women for 5 weeks to increase their knowledge and practices about dengue, Zika, and chikungunya. Pre-and-post surveys and focus group discussions were conducted in community settings to measure the feasibility and acceptability of this intervention. Chat reviews were done to assess the usability of users. A total of 1566 messages were exchanged in 45 WhatsApp chats. High acceptance and good usability (82% of users used the app for replying) were reported in this study. WhatsApp messages were perceived as short, clear, and enjoyable. Users liked the frequency, and design of messages. Pre- and post-surveys demonstrated improvements in the knowledge and practices of arboviral diseases. The intention to apply this knowledge in practice was reflected in a significant improvement, particularly in cleaning the laundry tank once a week (pre 62.1% to post 89.6%, p < 0.008). This study suggests that using WhatsApp as an additional tool could be a feasible, acceptable, and affordable strategy for improving the adoption of better practices in the prevention of arboviral diseases.

The Use of Patient-Oriented Mobile Phone Apps in Oral Health: Scoping Review

BACKGROUND

Oral health is a significant part of general health. Poor oral health can influence an individual's appearance, self-esteem, eating, and speaking. The use of mobile phone apps has been growing in the field of medicine, including dentistry. However, to date, there is no evidence related to the availability of mobile apps focusing on various branches of dentistry.

OBJECTIVE

The aim of this study was to review the scientific literature on the use of patient-oriented mobile phone apps in oral health and summarize the key findings.

METHODS

A scoping review of published scientific literature on the use of patient-oriented mobile phone apps in oral health was conducted in accordance with the Joanna Briggs Institute. A search was performed in PubMed and Scopus for studies published between January 2000 and June 2021 that were written in English. All study types except for those reporting developmental protocols were included in this review. In total, 2 reviewers independently screened the studies using the eligibility criteria. The study protocol was registered in the Open Science Framework registries in June 2021.

RESULTS

The initial search yielded a total of 977 studies, 45 (4.6%) of which met the inclusion criteria. All the studies (45/45, 100%) were published after 2009. Most studies (31/45, 69%) concerned oral health promotion using mobile phone apps, followed by behavior management (5/45, 11%). More than half (23/45, 51%) of the included studies were conducted in Asian countries. Overall, 31% (14/45) of the studies focused on adolescents. A total of 51% (23/45) of the studies were randomized controlled trials (RCTs). Approximately 39% (9/23) of the included RCT studies reported a substantial reduction in dental plaque, and 26% (6/23) of the studies reported significant improvement in gingival health. Regarding dental anxiety management, 13% (3/23) of the RCT studies reported a significant decrease in mean heart rate and lower Facial Image Scale scores.

CONCLUSIONS

According to the literature, the use of mobile apps in oral health is increasing among patients, mainly children and adolescents. Many studies that have used mobile apps have focused on promoting oral health. However, other areas such as diagnostic and remote consultations (teledentistry) have until recently been neglected despite their great potential.

Health belief model for empowering parental toothbrushing and sugar intake control in reducing early childhood caries among young children-study protocol for a cluster randomized controlled trial

Background

It has been recognized that oral health education for parents is critical for preventing early childhood caries (ECC). Few parents practiced caries prevention procedures for their children in daily life, though. A novel intervention scheme using mobile messages will be developed in this study under the framework of the health belief model (HBM). The objective of the present randomized clinical trial (RCT) is to evaluate the effectiveness of the new scheme in promoting oral health of young children by reducing dental caries.

Methods

This RCT will involve 26–36 child care centers or kindergartens with nursery classes (clusters) located in Hong Kong. A total of 518–628 child-parent dyads (child age 18–30 months) will be recruited and randomly allocated at the cluster level into the test or control group with a 1:1 ratio. For parents in the test group, the intervention will consist of a set of HBM-based text messages sent regularly in 48 weeks. A standard text message will be sent to the parents in the control group in the first week. The primary outcome will be dental caries measured by dmft/dmfs of the children after 2 years (around 4 years of age). The secondary outcomes will be toothbtushing and sugar intake.

Discussion

HBM-based intervention via a low-cost text messaging vehicle may serve as a viable way to empower parents to establish proper oral health behaviors for their children and safeguard the oral health of children in Hong Kong.

Trial registration

ClinicalTrials.govNCT04665219. Registered on 11 December 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06208-w.

Risk Indicators for Early Childhood Caries in South Africa: Protocol for a Systematic Review

Background

Early childhood caries (ECC) is a common disorder characterized by the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces of primary teeth in children 71 months old or younger. South Africa has a diverse population in terms of culture, education, income, and occupation. This diversity is due to the consequences of historical racial discrimination, poverty, unemployment, lack of accessibility to health services, and quality of education. These factors make South Africa unique, and the disease and risk profiles for this country differ from those of other countries at similar stages of development. For these reasons, it is important to identify the unique maternal and infant risk factors for ECC in the South African context.

Objective

The purpose of this study is to determine the risk factors associated with the incidence and prevalence of ECC in South Africa in children under the age of 6 years.

Methods

All cross-sectional and cohort studies documenting risk factors associated with the prevalence and incidence of dental disease and severity (decayed, missing, and filled scores) will be included. We will search 7 databases for eligible studies, and those included will be based on prespecified inclusion criteria. Only studies conducted with South African children who are aged 6 years and younger in which dental caries risk factors are documented will be included. There is no restriction on the time or language of publication. Included articles will be scrutinized for quality by using a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be performed.

Results

The literature search was conducted in November 2020.

Conclusions

The results of this study will provide a framework to inform medical and dental personnel to highlight mothers and infants at risk of developing ECC.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42020216455; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216455

International Registered Report Identifier (IRRID)

DERR1-10.2196/26701

Parental-oriented educational mobile messages to aid in the control of early childhood caries in low socioeconomic children: A randomized controlled trial

OBJECTIVES

To evaluate the effectiveness of educational messages as an aid in the control of early childhood caries (ECC) in low socioeconomic children.

METHODS

A single-blinded, randomized, and parallel-group study was conducted with 104 dyads of parents and children aged between 36-60 months, recruited in preschools from Bauru, Brazil. The participants were randomly allocated into control and intervention groups (1:1), stratified by parental eHealth literacy scores (eHEALS) and children's caries experience. Every 2 weeks, text messages were sent to parents of intervention group via WhatsApp. Visible plaque index (VPI) and the International Caries Detection and Assessment System (ICDAS) were assessed at baseline, 3- and 6-month follow-ups, while eHEALS and dietary habits were determined at baseline and 6-month follow-up. Statistical analysis was performed to intra and intergroup comparisons through Fischer's exact and McNemar tests, and Mann-Whitney U and Friedman tests, respectively (P < 0.05).

RESULTS

Despite similarities between groups, intervention increased parental eHEALS scores, influencing the reports about the children's consumption of sugar-free sweets and controlling the severity of ECC.

CONCLUSION

Therefore, mobile text messages were effective to control the severity of ECC in low socioeconomic preschoolers, improving parental eHealth literacy and changing children's dietary patterns.

CLINICAL SIGNIFICANCE

These findings demonstrate that parental-oriented WhatsApp messages can contribute to oral health education of socioeconomic vulnerable parents towards risk behavior changes to control ECC.

[Social inequalities in oral health and early childhood caries: How can they be effectively prevented? A scoping review of disease predictors]

BACKGROUND

Early childhood caries represent a major public health problem. In addition to their individual impact, the massive social inequalities in oral health that are at the roots and result from the disease have largely underestimated consequences for the child, his family and the community. In response to the question of "how and where to act?", this scoping review identifies the individual characteristics associated with the disease on which it would be possible to act, using appropriate prevention strategies.

METHODS

This scoping review is aimed at describing and analyzing available data in the literature on the different factors associated with early childhood caries.

RESULTS

The predictors of early childhood caries are represented by mediating (knowledge, attitudes and parents' oral health practices) and moderating (psychosocial parameters, parental health literacy and alcohol consumption) factors. Twenty-eight articles fulfilled the selection criteria, twenty of which studied mediators related to early childhood caries, and fourteen of which dealt with moderators. The lower the parents' level of knowledge and literacy in oral health, the higher a child's dmft index. Additional studies are needed to assess the role of psychosocial parameters.

CONCLUSION

Parents' knowledge and oral health literacy are the key predictors to be preferentially targeted in view of reducing social inequalities in health through actions undertaken on a local scale. The prevention of early childhood caries necessitates a combination of generic and targeted interventions.

Parental perspectives on early childhood caries: A qualitative study

BACKGROUND

Early childhood caries (ECC) affects about 621 million children worldwide, causing chronic pain, infections, sleeping disorders, and tooth extraction.

AIM

To determine perspectives of parents and caregivers of preschoolers regarding ECC.

DESIGN

Three focus groups were conducted with attendees of the Clinics of Paediatric Dentistry from the Bauru School of Dentistry. The meetings were video- and audio-recorded, and the contents were transcribed verbatim. Then, textual passages were examined and coded using the software NVivo 12 Plus.

RESULTS

The participants associated the presence of dental caries lesions with negative consequences for children, such as problems for permanent dentition, discrimination, and psychological damages. Although regular oral hygiene and healthy diet were recognized as important factors for the prevention of ECC, specific doubts about feeding, toothpaste usage, oral hygiene, and dental eruption were detected among parents. Additionally, they declared that their children brush teeth alone, intake fermentable carbohydrates frequently, and sleep during breastfeeding without dental plaque removal, because uncooperativeness, permissiveness, and convenience.

CONCLUSIONS

Based on these results, parents and caregivers understand the unfavourable effects of ECC on children's quality of life; however, their attitudes against the disease seemed to be inaccurate, influenced by their daily routines, doubts, and beliefs.