Effectiveness of Mobile Health Applications Compared to Conventional Motivational Interviewing in Improving Toothbrushing Duration and Its Impact on Dental Caries Among 6-12-year-old Children: 12-month Randomized Controlled Trial.

AIM AND BACKGROUND: Toothbrushing for 2 minutes twice daily is a well-established preventive strategy against dental caries. However, compliance among children remains poor, and traditional motivational methods often fail to sustain behavior change. mHealth apps offer interactive features to improve brushing habits, yet evidence linking their use to improved brushing duration and clinical outcomes remains limited. This study aimed to compare the effectiveness of two dental apps (Brush DJ app and Brushing Time app) with conventional face-to-face motivational interviewing in improving toothbrushing duration and to assess their impact on oral hygiene and caries incidence among children aged 6-12 years. MATERIALS AND METHODS: A 12-month, 3-arm, parallel-group, assessor-blinded randomized controlled trial was conducted with 120 children (40 per group). Participants were randomized to Brush DJ app, Brushing Time app, and motivational interviewing. Brushing duration, OHI-S Debris Index, and dmfs/DMFS index were assessed at baseline and at 3, 6, 9, and 12 months. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests, with significance set at p < 0.05. RESULTS: At 12 months, Brush DJ achieved the highest mean brushing duration (104.9 seconds), significantly greater than the face-to-face group (82.0 seconds; p = 0.033). The Brushing Time app recorded a mean of 100.5 seconds, not significantly different from Brush DJ. OHI-S scores improved most in the Brushing Time app group (1.0), followed by Brush DJ (1.03), both significantly better than face-to-face (1.4; p < 0.05). Caries incidence (dmfs/DMFS) showed marginally lower scores in the app groups (Brushing Time app: 4.6; Brush DJ app: 4.8) compared to face-to-face (5.1), though differences were not statistically significant. CONCLUSION: Both the Brush DJ app and the Brushing Time app were more effective than face-to-face counseling in improving brushing duration and oral hygiene. CLINICAL SIGNIFICANCE: Freely available mHealth apps offer a promising, accessible, and sustainable adjunct to traditional counseling in promoting better toothbrushing habits and oral health in children.