Text messages 'help improve teen tooth health'

Text message reminders can help improve toothbrushing habits in teenagers, particularly those from low-income families, a new study has shown.

In collaboration with the Universities of Sheffield, Cardiff, York and Dundee, researchers in the School of Dentistry investigated the effectiveness of a new programme designed to encourage better brushing habits and reduce tooth decay in secondary school pupils.  

Tooth decay is very common, affecting a third of young people aged 12-15. This increases to nearly half of youngsters living in areas of poverty. Young people with tooth decay often suffer from toothache, loss of sleep and problems eating, as well as effects on their overall physical health and mental wellbeing. It can also lead to increased school absences.  

The BRIGHT trial, funded by the National Institute for Health and Care Research (NIHR) and published in the Journal of Health Technology Assessment, included a classroom lesson and twice-daily text messages about toothbrushing. The research involved 4,680 students from 42 secondary schools across England, Scotland and Wales. Their teeth were checked at the start of the study and after two and a half years. Pupils were surveyed after six months about their toothbrushing habits. 

Pupils who received the lesson and text messages reported brushing their teeth more often after six months but did not have less tooth decay or plaque after two and half years.  

The adolescent years are a critical time when independent toothbrushing practices are established and continue into adulthood.

However, the analysis found some evidence of the prevention of tooth decay among pupils eligible for free school meals, suggesting the programme may be particularly beneficial for students from low-income families, helping to reduce inequalities in oral health.    

Peter Day, Professor and Consultant in Paediatric Dentistry at the University of Leeds, who co-led the BRIGHT trial, said: “School-based oral health initiatives for young children are not new, but there has been very little for secondary school pupils, despite the high levels of tooth decay seen in this group. 

“The adolescent years are a critical time when independent toothbrushing practices are established and continue into adulthood – which is why it is vital to help teenagers understand the importance of preventing tooth decay and the benefits of effective toothbrushing with fluoride toothpaste.” 

The text messages and lessons were well-received by students and teachers. The lesson plans have been downloaded almost 1,000 times since the end of the study.   

Tooth decay ‘hits school attendance’

Sue Pavitt, Professor and Director of the Dental Translation & Clinical Research Unit, University of Leeds, who co-led the BRIGHT trial across West Yorkshire Schools, said: “We continue to build on the BRIGHT trial to create new innovative opportunities to encourage secondary school and sixth form colleges students to be empowered and gain basic skills and knowledge to improve their own oral health and behaviours. There is much enthusiasm from school communities who recognize the impact that tooth decay and toothache has on absenteeism, bullying and low self-esteem.” 

 Researchers will now use these results to find better ways to help secondary school pupils keep their teeth healthy. The study also highlighted the need to better understand the factors that influence oral health habits in teenagers, particularly sugar consumption    

James Colliver, Lead Learning Manager at Outwood Academy City, Sheffield took part in the BRIGHT trial. 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.”    

Dental health is now the statutory content of the health education curriculum for primary and secondary schools in England. The BRIGHT trial involved the development and evaluation of a new intervention which covers the dental health content for secondary schools.  

Additional information  

• “Behaviour change intervention (education and text) to prevent dental caries in secondary school pupils: BRIGHT RCT, process and economic evaluation” is published in Health Technology Assessment. 
• For more information or to arrange interviews contact University of Leeds press officer Lauren Ballinger via email at l.ballinger@leeds.ac.uk.
• Main image credit: Adobe Stock.