Effects of an Oral Health Chatbot Based on Protection-Motivation Theory on Plaque Reduction in Young Children: A Quasi-Experimental Study.

OBJECTIVE

The objective was to compare the effectiveness of hands-on toothbrushing training alone or in conjunction with conventional oral health education (OHE) or with the use of the 21-Day FunDee chatbot on the caregiver's oral hygiene care and plaque control for young children.

METHODS

A quasi-experimental, parallel, three-group pretest-posttest designed study was applied. The participants included 213 pairs of caregivers and children aged 6-30 months. Each group consisted of 71 pairs of caregivers and children. Participants were divided into three groups: Gr. I was the Hands-On (HO) in-person tooth brushing practice group, Gr. II was the Hands-On and Poster (HO + PO) group with in-person tooth brushing practice and OHE via posters and Gr. III was the Hands-On and Chatbot group (HO + CB) with in-person tooth brushing practice and 21-Day FunDee chatbot media. Oral examinations and a structured questionnaire compared oral hygiene behaviours, oral health perceptions, knowledge and plaque levels among the three groups at baseline and 35-45 days subsequently. Multiple linear regression was used to determine the difference between the three groups on plaque reduction.

RESULTS

The majority of caregivers were Muslim mothers. The plaque score reduction was 0.34 ± 0.30, 0.50 ± 0.23 and 0.52 ± 0.25 for Gr. I, II and III, respectively. Compared with the Hands-On group, there was a statistically significant difference in plaque reduction for the Hands-On and Poster group (p-value = 0.039) and the Hands-On and Chatbot group (p-value = 0.047). The baseline frequency of tooth brushing was an important determinant for plaque reduction (p-value = 0.007). However, there was no significant association between baseline knowledge, protection-motivation theory perceptions or educational levels regarding plaque reduction. Both conventional OHE and 21-Day FunDee chatbot media received high user satisfaction ratings.

CONCLUSION

Caregiver-assisted toothbrushing, combined with either conventional oral health education or chatbot support, significantly improved oral hygiene care and plaque control in young children compared with hands-on toothbrushing training alone.