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  = 99%, p < 0.001), and that of gingival bleeding (n = 7 studies) was -8.54 (95% CI -13.16 to -3.91; I  = 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.