New research combats tooth decay with text messaging

Dental Tribune International

Fri. 15. November 2024

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SHEFFIELD, England: One crucial dimension of the UK National Health Service dental crisis is without question its impact on children and young people. As a recent research report has shown, dental caries and related extractions and hospital admissions are now represented at alarming levels among this demographic. In an attempt to combat this disturbing trend, a combined group of researchers from the universities of Sheffield, Cardiff, Leeds, York and Dundee have developed the BRIGHT trial, a systematic effort to improve young people’s oral health outcomes through various preventive measures. One of these strategies aims to utilise mobile phones—the devices that few teenagers can do without.

Funded by the National Institute for Health and Care Research, the BRIGHT trial included a classroom lesson and two text messages each day about toothbrushing. The research involved 4,680 students aged 11–14 from 42 schools across England, Scotland and Wales.

The urgency of the study and intervention was communicated vividly by James Colliver, lead learning manager at Outwood Academy City in Sheffield. In a University of Sheffield press release, he said: “We have a lot of students losing their teeth so I felt it was definitely worthwhile. One of the girls, aged 12, who was in the class told me she’d already had eight teeth out, so that made it feel like this was really important.”

So, how effective was the trial? The results were mixed. On the one hand, the trial clearly resulted in an improvement in the group’s brushing habits after six months. On the other hand, this positive behavioural change did not translate into a reduction of caries.

Prof. Zoe Marshman from the University of Sheffield’s School of Clinical Dentistry co-led the BRIGHT trial. Despite the ambivalent findings, she emphasised the necessity of such efforts in raising awareness among teenagers and secondary school students about the importance of oral health.

“Tooth decay and all its negative consequences such as toothache, loss of sleep and problems eating are very common in children of secondary school age. While school-based initiatives for children between the ages of 4–11 have been delivered for decades, there is very little for secondary schools,” Prof. Marshman said.

She added: “However, this is a critical stage for toothbrushing practices to become an established behaviour for adulthood. This is why it is vital to help young people to improve their understanding of the importance of toothbrushing and skills to prevent tooth decay.”

The study, titled “Behaviour change intervention (education and text) to prevent dental caries in secondary school pupils: BRIGHT RCT, process and economic evaluation”, was published in September 2024 in Health Technology Assessment.