Text messaging may improve oral health knowledge, attitudes and practices


The aim of this study was to compare the effectiveness of delivery oral health messages by text messages and pamphlets to mothers of pre-school children. The study was conducted in India and restricted to mothers with mobile phones who could speak English.

Mothers were randomised to received 3 text messages per day ( text message group)  or a daily pamphlet ( pamphlet group ). Clinical examination of the children was undertaken before and after the intervention.  Mothers completed a pre- and post intervention, knowledge, attitude and practices (KAP) questionnaire.  The intervention lasted 4 weeks.

143 mother and children completed the study. Seven participants dropped out of the study (3 in the  pamphlet group 4 in the text message group)

They found

  • Both groups showed improvements
  • Significant improvement in KAP in the text message group compared to the pamphlets group
  • Significant reduction in visible plaque scores (P < 0.001) in both groups.

The authors concluded

Text messaging was more effective than pamphlets in improving knowledge, attitude and practices of mothers, but the comparative reduction in plaque score between groups was not significant. Text messaging appears to be an effective means of imparting oral health education.

Sharma R, Hebbal M, Ankola AV, Murugabupathy V. Mobile-phone text messaging (SMS) for providing oral health education to mothers of preschool children in Belgaum City. J Telemed Telecare. 2011;17(8):432-6. Epub 2011 Oct 24. PubMed PMID: 22025742


This is an interesting study which shows some modest short terms gains in oral health knowledge, attitudes and practices.  However, it should be noted that this is only short -term study.  The text messaging regimen of 3 per day may seem a little intrusive, interestingly only two mothers were irritated enough to drop out.   A longer intervention of this intensity may result in further drop-outs,  so it may be interesting to see the results from different texting regimes.   It is also worth noting that the KAP scores are self-reported with the main objective outcome of the child’s visible plaque score showing no significant difference.

Currently a Cochrane review of,  phone messaging for preventive health care is under way as part of a suite of reviews looking as the role of mobile phone messaging in health care.

Vodopivec-Jamsek V, de Jongh T, Gurol-Urganci I, Atun R, Car J. Mobile phone messaging for preventive health care (Protocol). Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD007457. DOI: 10.1002/14651858.CD007457.




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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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