Text Messaging Can Improve the Oral Health of At-Risk Children

Dentistry Today


Text message interventions have the potential to improve the oral health of at-risk children by positively influencing their caregivers’ attitudes and behaviors towards the oral health of those children, according to researchers at the Boston University Henry M. Goldman School of Dental Medicine

“The most effective interventions are those that are integrated into the daily fabric of people’s lives,” said Belinda Borrelli, PhD, the study’s lead co-principal investigator and professor of health policy and health services research at the school, where she also directs the Center for Behavioral Science Research.

“Through text messaging, we can target previously unreachable populations with evidence-based information that they can access in real time—most people carry their cell phones throughout the day—wherever they happen to be when the text comes in,” said Borrelli. 

The feasibility trial explored the efficacy of harnessing the power of text messaging to improve pediatric oral health among at-risk populations. Currently, more than 95% of adults use text messaging with no disparities in race, ethnicity, and income. These at-risk populations have disproportionate rates of untreated dental decay and lack adequate access to dental care.

The researchers developed a text-message program focused on motivating adherence to pediatric oral health behaviors. They based the program content and structure on clinical guidelines as well as on feedback from a multidisciplinary scientific advisory board, the medical community, and parents in the target population.

Subjects were parents or caregivers of children who were patients of pediatric clinics in two community health centers in an urban and underserved area of Boston. They were randomized to receive either oral health text messages or child wellness text messages. The text messages in both groups were interactive, focusing on problem-solving barriers to behavior change.

There were four main findings from the eight-week feasibility trial:

  • Participants were very satisfied with the program.
  • Participants in both the treatment and control groups demonstrated a high level of engagement as measured by their responsiveness to the texts.
  • The intervention had a positive influence on parents’ attitudes toward oral health and social-cognitive mediators.
  • The oral health text message program showed preliminary effectiveness at increasing brushing behaviors in participants randomized to the treatment group compared to the control group.

These findings indicate that the intervention as designed was effective at reaching and engaging its target audience, the researchers said. Also, the findings demonstrate the potential of the intervention to change behavior and beliefs related to oral health, the researchers said. 

Based on the results of the feasibility trial, the researchers secured funding from the National Institute of Dental and Craniofacial Research to conduct a larger trial on the text message intervention. Currently, 650 families are enrolled in the study.

“This study demonstrates the potential of text message interventions and provides evidence that a larger, fully powered randomized controlled trial is needed,” said Borelli. “This is the type of program that, if proven effective, could be disseminated nationally to other federally qualified pediatric clinics (patient treatment centers) and ultimately make a real difference in the oral health of at-risk children.”

The study, “An Interactive Parent-Targeted Text Messaging Intervention to Improve Oral Health in Children Attending Urban Pediatric Clinics: Feasibility Randomized Controlled Trial,” was published by the Journal of Medical Internet Research-mHealth and uHealth.

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