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

Researchers from the University of Leeds, in collaboration with the Universities of Sheffield, Cardiff, York and Dundee, investigated the effectiveness of a 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 to 15. This increases to nearly half of teenagers living in areas of poverty. Young people with tooth decay often suffer from toothache, loss of sleep and problems eating. Also, it can affect their overall physical health and mental wellbeing and can lead to increased school absences.

The study

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.

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, 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.

Sue Pavitt, a professor and director of the Dental Translation and Clinical Research Unit at the University of Leeds, 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 recognise the impact that tooth decay and toothache has on absenteeism, bullying and low self-esteem.”

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

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