The effectiveness of theory-based WhatsApp reminders on oral hygiene status and practices among adolescents

Abstract

Objective: This study aimed to evaluate the effectiveness of a theory-based WhatsApp reminder intervention on oral hygiene behavior and plaque index among adolescents. Material and Methods: Employing a quasi-experimental pretestposttest control-group design, the study involved 111 senior high school students in Jember District, Indonesia, divided into an intervention group (n=54) and a control group (n=57). The intervention consisted of sending educational and motivational messages three times a week at 8:00 p.m. for four weeks to target pre-sleep routines, while outcomes, including the Plaque Index (PI), observed brushing skills, and self-reported oral health knowledge, attitude, and practice (KAP), were analyzed using ANCOVA and binary logistic regression. Results: The intervention group achieved a significantly lower adjusted PI (0.52) compared to the control group (0.74, p<0.001) and a significantly higher adjusted mean practice score (p<0.001). Students in the intervention group were 6.84 times more likely to adopt the correct brushing method compared to the control group (p = 0.006). The statistical analysis revealed no significant differences between groups in terms of oral health knowledge, attitude, brushing duration, and completeness of brushing area (p > 0.05). Conclusion: WhatsApp-based reminders serve as effective, scalable cues to action that successfully bridge the gap between knowledge and practice, significantly improving clinical oral hygiene status and brushing method.

KEYWORDS

Adolescent; Health behavior; Mobile applications; Oral health; Oral hygiene.