Are technology-based health education methods able to reduce oral health inequalities between the sexes in adolescents? A cluster randomized trial.

Abstract

Determine if different technology-based health education interventions can reduce oral health inequalities between the sexes in a sample of adolescents. A cluster randomized clinical trial was conducted in three phases with an initial sample of 291 male and female adolescents 14-19 years of age. Phase I (n=288) comprised a clinical examination performed by a calibrated examiner using the simplified oral hygiene index (OHI-S) and gingival bleeding index (GBI). Phase II involved two educational interventions: video (VD; n=147) or oral counselling (OR; n=141) with standardized content. In phase III, an App was made available to half of the clusters (OR + App; n=66/OR without App; n=71/VD + App; n=63/VD without App; n=63), and the clinical examination was performed a second time. Data were evaluated using descriptive analysis and nonparametric tests. In phase I, boys had a lower standard of oral hygiene compared with girls, with higher mean OHI-S (p=0.039) and GBI (p=0.015). After VD and OR interventions, no significant difference between sexes was found regarding the mean OHI-S. However, males had a higher mean GBI compared with females in the OR group (p=0.006). When the App was added to OR and VD groups, males in the 'OR without App' group had a higher mean GBI compared with females (p=0.007). This clinical trial demonstrated that educational interventions involving information technologies were effective at reducing oral health inequalities between the sexes among adolescents. However, oral counselling alone was not efficient in reducing GBI in male adolescents.