Improving Gum Health Among Older Adults in Hong Kong Through Artificial Intelligence-Based Mobile Health for Personalized Oral Hygiene Instruction
Trial ID: NCT07187453
Status: ACTIVE_NOT_RECRUITING
Study type: INTERVENTIONAL
Phase: NA
Start date: 2025-09-10
Completion date: 2026-07-10
Sponsor: The University of Hong Kong
Conditions: Gum Inflammation; Periodontal Diseases; Oral Hygiene, Oral Health
Interventions: Personalized Oral Hygiene Advice using AI assisted mHealth Tool by Non-Dental Personnel
Locations: Prince Philip Dental Hospital
Countries: Hong Kong
Enrollment: 88
Age range: 60 Years - None
Sex: ALL

Summary:
Background: Many older adults in Hong Kong lack thorough tooth cleaning and regular dental check-ups, which can lead to plaque-induced gum diseases and systemic health issues. A self-developed Mobile Health (mHealth) system, which utilizes smartphone photographs and artificial intelligence (AI), has been shown to accurately detect gum health. Personalized oral hygiene instruction (POHI) can then be provided based on the detected results.

Objectives:

1. To improve gum health among non-institutionalized older adults using mHealth and POHI.
2. To evaluate the clinical effectiveness of mHealth and POHI in improving gum health.

Hypothesis: The personalized oral hygiene instruction (OHI) in addition to AI based mHealth provided by volunteer social workers can improve clinical effectiveness and oral health related quality of life (OHRQoL).

Design and subjects: 88 older adults will be recruited from daycare centers, who will receive bi-weekly POHI based on their gum condition, detected by mHealth which is provided by trained volunteers.

Two calibrated assessors will assess the participants' gum health, oral hygiene, caries, dental plaque, and structured questionnaire at baseline, after 3 months, 6 months, 9 months and 1 year Study Instruments: Gingival Index, Plaque Index, International Caries Detection and Assessment System (ICDAS) code, dental plaque microbiology, and Geriatric Oral Health Assessment Index (GOHAI) + Structured Questionnaire.

Interventions: Personalized oral hygiene instruction using AI-powered mHealth provided by trained volunteers bi-weekly Main Outcomes: Gingival condition, Oral hygiene status, Dental plaque microbiology, and oral health-related quality of life.

Data analysis: t-tests and Wilcoxon rank-sum test will compare pre- and post-intervention data.

Expected Result: The use of mHealth and POHI provided by trained volunteers bi-weekly can lead to improved gum health among older adults.

Eligibility criteria:
Inclusion Criteria:

* Subjects aged ≥60 years and able to give informed consent:
* Subjects who are mentally and cognitively healthy
* Subjects who have at least 20 anterior maxillary or mandibular natural teeth including incisors and canine.
* Subjects who can speak, read, or understand Cantonese for complete the satisfaction questionnaire.
* Subjects who can practice oral hygiene procedure (regular tooth brushing and interdental cleansing/flossing/brushing) daily on their own independently.

Exclusion Criteria:

* Subjects who have less than 20 anterior maxillary or mandibular natural teeth with or without dental prostheses in those area.

  * Subjects who have mental illness, or similar problems that unable to complete the satisfaction questionnaire.
  * Subjects who cannot perform oral hygiene procedure (regular tooth brushing and interdental cleansing/flossing/brushing) by any condition of oral cavity such as tumor or maxillomandibular fixation.
  * Subjects who cannot attend weekly oral hygiene instruction at centers.

Outcomes:
Plaque Index; Gingival Index