Text message reminders can help to improve tooth brushing habits in teenagers, particularly in low-income families, a new study shows.
Educating children at secondary schools on the benefits of brushing their teeth and following up with daily text message reminders increased teeth brushing amongst all pupils.
Children who qualified for free school meals benefited most from the programme, showing a reduction in tooth decay and improved oral health, suggesting the intervention could help reduce inequalities in oral health experienced by children from low-income families.
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The findings are published in the journal Health Technology Assessment.
Tooth decay affects one-third of children aged 12-15 in the UK, rising to nearly half in low-income areas and affects both physical and mental health. Poor oral health can lead to toothache, sleep loss, problems eating and increased school absences.
Researchers at the University of Leeds designed and led the study to determine the intervention’s clinical effectiveness and cost benefits. The study, which was part of the BRIGHT trial, involved 4,680 pupils from 42 secondary schools across England, Scotland and Wales.
Based on behaviour change theory, the two-part intervention included a 50-minute lesson delivered by teachers, followed by twice-daily text messages to pupils’ mobile phones about toothbrushing. The researchers examined the children’s teeth for dental caries and general oral health, such as the presence of plaque or bleeding at the start of the study and after two and a half years. The pupils were also surveyed after six months about their tooth brushing habits and the findings were compared with pupils undergoing routine education without the intervention.
After six months, pupils who received oral health interventions reported brushing their teeth more often. However, after two and a half years, this did not translate into a reduction in dental caries, such as tooth decay and cavities.
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Among children eligible for free school meals, there was evidence that the intervention prevented some tooth decay, suggesting the programme may be particularly beneficial to teenagers from low-income families.
The researchers suggest that future work with secondary school pupils should focus on how toothbrushing and sugar consumption can affect oral health, with a particular focus on children who are eligible for free school meals.
Peter Day, Professor and Consultant in Paediatric Dentistry at the University of Leeds, who co-led the BRIGHT trial, said: ‘School-based oral health initiatives for young children are not new, but there has been very little for secondary school pupils, despite the high levels of tooth decay seen in this group.’
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He added: ‘The adolescent years are a critical time when independent toothbrushing practices are established and continue into adulthood – which is why it is vital to help teenagers understand the importance of preventing tooth decay and the benefits of effective toothbrushing with fluoride toothpaste.’
