Effect of mHealth in improving oral hygiene: A systematic review with meta-analysis

Aim To evaluate the effectiveness of mobile applications and text messages, compared with conventional oral hygiene instructions, for improving oral health knowledge and/or reducing gingival inflammation, when delivered to adolescents, adults and mothers of young children. Methods Randomized clinical trials evaluating the use of mobile applications or text messages related to oral hygiene and/or oral health education were screened. A search was performed in the Medline-PubMed, Scopus and Embase databases and the grey literature. The eligible studies comprised those related to plaque, gingival bleeding and/or oral health knowledge as outcomes. The risk of bias was assessed with the Cochrane tool and the GRADE system. Two meta-analyses were carried out. Results Among the fifteen studies selected, twelve (80%) used text messages and thirteen (87%) showed better results when mobile technology was used. The pooled SMD for the dental plaque index (n = 10 studies) was -9.43 (95% CI -14.36 to -4.495; I-2 = 99%, p < 0.001), and that of gingival bleeding (n = 7 studies) was -8.54 (95% CI -13.16 to -3.91; I-2 = 99%, p < 0.001), indicating significant improvement in dental plaque control and gingival bleeding for groups that received the mobile health (mHealth) strategy. Conclusion mHealth can be used as an adjunct component in managing gingivitis, acquiring oral health knowledge and improving oral hygiene.