Utilizing Teledentistry to Deliver Pediatric Oral Health Education to Caregivers

Purpose: This randomized controlled trial assessed the effect of motivational interviewing (MI) using teledentistry on nighttime oral health behaviors in children under three years old. The study hypothesized the intervention would improve oral health behaviors more effectively than written educational materials alone. Methods: Sixty-four participants were recruited from a hospital-based pediatric medical clinic between August-October 2023. Inclusion criteria were English-speaking caregivers of healthy children aged 6-35 months without prior dental treatment. Caregivers completed a baseline questionnaire then received oral hygiene products and a printed oral health education pamphlet during their child's primary care visit. After simple randomization, the intervention participants completed a 15-minute teledentistry session 30-45 days after enrollment. Both intervention and control groups completed a follow-up questionnaire 60-75 days after enrollment, focusing on primary outcomes: toothbrushing/cleaning frequency, fluoride toothpaste usage, and bottle use. Descriptive and bivariate analyses were performed with statistical significance set at α<0.05. Results: Caregivers were 94% mothers, mean age 29.1 years (SD=5.6), 56% Black, 19% White, and 25% “Other” race with 36% identifying as Hispanic ethnicity. Children were 55% female, mean age 15.1 months (SD=7.5), and 81% Medicaid-enrolled. There were no significant baseline differences between the intervention and control groups’ demographics or oral health behaviors. There was a 41% loss to follow-up equally distributed between both groups; 38 participants (N=19 control, N=19 intervention) were included in intention-to-treat analysis. Both the intervention (P=.04) and control (P=.008) groups showed improvement in toothbrushing/cleaning frequency. The MI intervention decreased nighttime bottle usage (P=.01) and increased fluoride toothpaste use (P=.003), whereas the verbal/written education showed no significant effects on oral health behaviors in the control group. Conclusions: While verbal/written educational materials can improve children's oral health behaviors, MI teledentistry interactions offer effective and accessible education to caregivers from low socioeconomic primary care settings.