Impact of Oral Health Chatbot With and Without Toothbrushing Training on Childhood Caries

Jaranya Hunsrisakhun; Supawadee Naorungroj; Watcharawalee Tangkuptanon; Pissamai Wattanasit; Kittiwara Pupong; Samerchit Pithpornchaiyakul

doi:10.1016/j.identj.2024.09.028

Impact of Oral Health Chatbot With and Without Toothbrushing Training on Childhood Caries

Int Dent J. 2024 Oct 22:S0020-6539(24)01541-7. doi: 10.1016/j.identj.2024.09.028. Online ahead of print.

Authors

Jaranya Hunsrisakhun¹, Supawadee Naorungroj², Watcharawalee Tangkuptanon³, Pissamai Wattanasit⁴, Kittiwara Pupong⁵, Samerchit Pithpornchaiyakul⁶

Affiliations

¹ Improvement of Oral Health Care Research Unit, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
² Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
³ Faculty of Engineering, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
⁴ Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
⁵ Maelan Hospital, Maelan, Pattani, Thailand.
⁶ Improvement of Oral Health Care Research Unit, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Electronic address: samerchit.p@psu.ac.th.

PMID: 39443262
DOI: 10.1016/j.identj.2024.09.028

Abstract

Objectives: Standalone oral health chatbots targeting young children's oral health are rare. The aim of this research was to compare the effectiveness of a standalone chatbot and a combination chatbot with in-person toothbrushing training for caregivers in improving young children's oral health.

Methods: A randomised, parallel, 2-group pretest-posttest design was employed with 320 caregiver-child pairs (aged 6-42 months). Group I (160 pairs) used the 21-Day FunDee (modified) chatbot along with in-person toothbrushing training, whilst Group II (160 pairs) used only the 21-Day FunDee Plus chatbot. Oral examination assessed plaque levels and caries, whilst a self-administered questionnaire evaluated oral hygiene care, dietary practices, and oral health perceptions based on the protection motivation theory (PMT). Data were analysed using 2-way repeated-measures analysis of variance, a t test, and chi-square measures for group comparisons.

Results: The majority of caregivers were Muslim mothers. No significant differences were observed between groups at the baseline, 3-month, and 6-month follow-ups in mean dmft (Group I: 4.16, 4.64, and 5.30 vs Group II: 4.30, 5.54, and 5.82), mean plaque scores (Group I: 0.72, 0.53, and 0.55 vs Group II (0.84, 0.52, and 0.59), and most dietary habits. However, significant improvements were found within groups from baseline to follow-ups in plaque reduction, toothbrushing practices, overall knowledge score, PMT perceptions, proper tooth brushing, fluoride toothpaste usage, and dietary behaviours (frequency of bottle feeding, frequency of nocturnal bottle feeding, proportion of children who went to bed without consuming anything after cleaning their teeth before bedtime). The significant differences between groups were found in self-efficacy at all time points, but only at the 6-month evaluation for percentage of fluoride toothpaste and overall PMT perceptions.

Conclusions: Both interventions were comparable in preventing caries, reducing plaque, improving feeding practices, increasing parental involvement in tooth brushing, and enhancing knowledge. The standalone chatbot 21-Day FunDee Plus presents a viable alternative for promoting oral health in young children.

Keywords: Caries; Chatbot; Children; Oral health behaviour; Plaque; Tooth brushing.