UCSF

Purpose: This randomized, prospective cohort study aimed to determine the effect educating parents about oral health via text messaging had on their children’s caries incidence.

Methods: A convenience sample of 95 parent/child pairs was recruited from the University of California, San Francisco (UCSF) Pediatric Dentistry clinic upon presentation for a new patient exam. Inclusion criteria included children ages 1-6, American Society of Anesthesiologists (ASA) classification 1 or 2 (generally healthy), and parents who were able to read and give consent in Spanish or English. Parent-child pairs were randomized into two groups (randomization based upon order of presentation). For one year, parents in the experimental group received texts with oral health information every 3 weeks, reminders to schedule 6-month recall appointments, and an appointment scheduling reminder via postcard (per clinic policy). The control group did not receive educational or appointment reminder text messages and instead only received reminders to schedule their recall appointments via the conventional postcard system. Data were collected for caries and restoration status using the international caries detection and assessment system (ICDAS) scoring system at the baseline evaluation and the 12-month recall appointment.

Results: Ninety five patient-parent pairs at the UCSF Pediatric Dentistry Clinic were randomized into two groups: control and experimental. Statistical analysis of the demographics of the experimental and control groups did not show a significant difference in preferred language, race, or parent age. ICDAS scores were compared between baseline and the one year visit at both the tooth surface and individual (patient) levels. The models noted whether there was improvement, no change or worsening of caries scores as measured by ICDAS. After one year, there was no significant difference in ICDAS scores between the two groups at the individual (p=0.5384) or surface (p=0.8553) levels.

Conclusions: Oral health education is offered as a part of the comprehensive oral examination to all pediatric dentistry patients at UCSF; however, there is a need to improve that communication to decrease caries incidence. Text messaging oral health information did not result in significant differences in incidence of new decay in UCSF pediatric dentistry patients after one year. Further research must be conducted to determine whether the caries incidence in this high risk population can be reduced with more frequent or effective education on oral hygiene and caries prevention, and to discover more efficacious communication strategies.