Mobile Phone Messaging To Improve Oral Hygiene Among Primary School Children in Pakistan
Condition: Oral Hygiene; Dental Plaque Induced Gingivitis
MeSH terms: Gingivitis; Dental Plaque
Study type: Interventional

Summary: 
      Oral health is an important component of general health and oral cavity acts as a mirror to
      the health of individuals and communities. Inadequate focus on primary prevention of oral
      diseases, poses a sizeable challenge for numerous countries, especially low and middle income
      countries.

      Mobile phone technology is relatively new and its successes in chronic disease is well
      documented but there is little evidence available in its use for improving oral health and
      dietary habits of children.

      This will be a Pilot Randomized Control Trial (RCT) . It will be conducted in public and
      private sector schools of Quetta city, Pakistan. Study will comprise of intervention and a
      control arm. Duration of intervention is 6 months.

      In the intervention group, study participants will be the parents. School teachers will send
      oral health education and reminder messages on frequent intervals to educate children's
      parents on oral hygiene and reinforce their behaviors to improve their child oral health.

      The primary school children in the control group will not receive any intervention
    

Detailed description: 
      Oral health is a vital part of general health and oral cavity is considered as a mirror to
      the health of individuals and communities. Poor oral health has a great impact on general
      health and several oral conditions are found to be associated with heart and lung diseases,
      diabetes, low-birth-weight and premature births. Oral conditions also affect the quality of
      life through affecting speech, eating, education, facial appearance, confidence and social
      interaction.

      Schools settings are important to reach children. School going age is considered as a
      receptive and influential phase in an individual's life during which lifelong health related
      behaviors, attitudes and beliefs are developed. Parents have great role in improving their
      children's oral health. They can influence their children oral health and behaviors and can
      provide a supportive environment to their children at home in terms of oral hygiene and diet
      and prevention of risk factors for oral diseases.

      Mobile phone text messaging is a powerful tool for changing behaviors as these are common,
      available, low-cost, and quick.(30) Text messaging can be utilized in reducing the global
      burden of diseases by promoting healthy behaviors and supporting disease prevention

      The main objective of this study is to assess the use of mobile phone (health) messages to
      Parents of public and private sector primary school children to improve their oral hygiene
      status

      This study will be a Pilot Randomized Control Trial (RCT), comprising of two arms
      Intervention and Control arm.

      In the intervention groups study participants will be the school teachers, parents and
      primary school children. School teachers will be provided messages (designed by Dental Public
      Health Professionals or adopted from other sources) through the researcher himself. The
      teachers will then form groups to send oral health education and reminder messages on
      frequent intervals to educate children's parents on oral hygiene and reinforce their
      behaviors to improve their child oral health. Parents will receive mobile phone messages
      about oral hygiene and healthy dieting of their children by the teachers. The message format
      will be text and images, depending upon the education/ literacy level of the parents. Parents
      will be reminded and information reinforced, at frequent intervals for a period of six
      months. School Children will be evaluated on their oral hygiene through gingival bleeding and
      plaque scores at the start of intervention, after three months and at the end of intervention
      i.e six months.

      The primary school children in the control group will not receive any intervention via their
      parents or teachers (in-active controls) but will be observed on selected outcome measures
      for baseline data, then at 3 months and at six month interval to compare for differences (if
      any) with intervention group.

      The total duration of this study is two years (2017 to 2018) including the intervention which
      will be of six months duration.

      After six months of start of intervention; both the intervention group and the control group
      will be assessed and evaluated on the primary outcome i.e. Oral hygiene measured through
      "Oral Hygiene Index" which is a standardized index for assessing oral hygiene and recommended
      by World health Organization.
    

Intervention name(s): Mobile Phone Messaging
Intervention type(s): Behavioral
Intervention description(s): Parents of primary school children will receive "Mobile Phone Messages" regarding their children's oral hygiene maintenance and their positive dietary habits.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: mHealth; Oral Health; Primary School Children; Mobile Phone Messaging