Effects of an Oral Health Chatbot Based on Protection‐Motivation Theory on Plaque Reduction in Young Children: A Quasi‐Experimental Study

OBJECTIVE: The objective was to compare the effectiveness of hands-on toothbrushing training alone or in conjunction with conventional oral health education (OHE) or with the use of the 21-Day FunDee chatbot on the caregiver's oral hygiene care and plaque control for young children. METHODS: A quasi-experimental, parallel, three-group pretest-posttest designed study was applied. The participants included 213 pairs of caregivers and children aged 6-30 months. Each group consisted of 71 pairs of caregivers and children. Participants were divided into three groups: Gr. I was the Hands-On (HO) in-person tooth brushing practice group, Gr. II was the Hands-On and Poster (HO + PO) group with in-person tooth brushing practice and OHE via posters and Gr. III was the Hands-On and Chatbot group (HO + CB) with in-person tooth brushing practice and 21-Day FunDee chatbot media. Oral examinations and a structured questionnaire compared oral hygiene behaviours, oral health perceptions, knowledge and plaque levels among the three groups at baseline and 35-45 days subsequently. Multiple linear regression was used to determine the difference between the three groups on plaque reduction. RESULTS: The majority of caregivers were Muslim mothers. The plaque score reduction was 0.34 ± 0.30, 0.50 ± 0.23 and 0.52 ± 0.25 for Gr. I, II and III, respectively. Compared with the Hands-On group, there was a statistically significant difference in plaque reduction for the Hands-On and Poster group (p-value = 0.039) and the Hands-On and Chatbot group (p-value = 0.047). The baseline frequency of tooth brushing was an important determinant for plaque reduction (p-value = 0.007). However, there was no significant association between baseline knowledge, protection-motivation theory perceptions or educational levels regarding plaque reduction. Both conventional OHE and 21-Day FunDee chatbot media received high user satisfaction ratings. CONCLUSION: Caregiver-assisted toothbrushing, combined with either conventional oral health education or chatbot support, significantly improved oral hygiene care and plaque control in young children compared with hands-on toothbrushing training alone.