Comparison of Oral Hygiene Orientation Through Teledentistry and Face-To-Face Tools in Randomized Clinical Trials
DOI:
https://doi.org/10.30953/thmt.v11.642Keywords:
COVID-19, health education, oral hygiene, pediatric dentistry, teledentistryAbstract
Background: Teledentistry has been utilized in public dental health to reduce waiting times and transportation costs. During the COVID-19 pandemic, it became an essential tool to minimize disruptions in dental care and promote oral health education remotely.
Aim: This study aimed to evaluate the effectiveness of virtual platforms and face-to-face consultations in improving children's oral hygiene.
Methods: A randomized controlled trial was conducted with 30 children, and their guardians, aged 6 to 10 years. Three groups based on the oral hygiene guidance were taken: 1) WhatsApp, 2) Video for Health platform, and 3) face-to-face. Oral hygiene was evaluated using the visible plaque index, brushing time, brushing method, flossing, toothpaste use, and adult supervision. Statistical analysis used Mann‒Whitney, Spearman's, Wilcoxon, Kruskal‒Wallis, and Fisher's Exact tests.
Results: The children’s mean age was 7.8 ± 1.5 years. All methods significantly reduced the plaque index and improved brushing habits (p < 0.05). There were no significant differences between the remote and face-to-face methods (p > 0.05). Guardians' involvement contributed to positive outcomes in children's oral health.
Conclusions: The study suggests that teledentistry is as effective as face-to-face consultations in improving children's oral hygiene and can be a viable alternative for remote oral health education.
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References
1. Gurgel BCV, Borges SB, Borges REA, Calderon PDS. COVID-
19: perspectives for the management of dental care and education.
J Appl Oral Sci. 2020;28:e20200358. https://doi.org/10.
1590/1678-7757-2020-0358
2. Coulthard P. Dentistry and coronavirus (COVID-19) – moral decision-
making. Br Dent J. 2020;228(7):503–5. https://doi.org/10.1038/
s41415-020-1482-1
3. Da Costa CB, Peralta FDS, Ferreira De Mello ALS. How has
teledentistry been applied in public dental health services? An integrative
review. Telemed J E Health. 2020;26(7):945–54. https://doi.
org/10.1089/tmj.2019.0122
4. Sharma H, Suprabha BS, Rao A. Teledentistry and its applications
in paediatric dentistry: a literature review. Pediatr Dent J.
2021;31(3):203–15. https://doi.org/10.1016/j.pdj.2021.08.003
5. Kanani H, Khubchandani M, Dangore-Khasbage S, Pandey R.
Teledentistry: a comprehensive review and its application in pediatric dental
care. Cureus. 2024;16(1):e52685. https://doi.org/10.7759/cureus.52685
6. Danesh DO, Luca J, Kalady SE, Townsend JA, Hammersmith KJ,
Meyer BD. The impact of teledentistry on travel distance and carbon
emissions at a children’s hospital. J Am Dent Assoc. 2025;156(2):144–
50. https://doi.org/10.1016/j.adaj.2024.11.007
7. Nuvvula S, Mallineni SK. Remote management of dental problems
in children during and post the COVID-19 pandemic outbreak: a
teledentistry approach. Dent Med Probl. 2021;58(2):237–41. https://
doi.org/10.17219/dmp/133182
8. Mola ME, Çogulu D, Eden E, Topaloglu A. Is teledentistry as effective
as clinical dental diagnosis in pediatric patients? Int J Paediatr Dent.
2025;35(4):783–91. https://doi.org/10.1111/ipd.13290
9. Gurgel-Juarez N, Torres-Pereira C, Haddad AE, Sheehy L,
Finestone H, Mallet K, et al. Accuracy and effectiveness
of teledentistry: a systematic review of systematic reviews.
Evid Based Dent. 2022;8:1–8. https://doi.org/10.1038/s41432-022-0257-8
10. Natal KH, Machado TG, Bracco F, Lemos LI, Vigano ME, Machado
GM, et al. Using information and communication technologies
(ICTs) to solve the repressed demand for primary dental care in the
Brazilian Unified Health System due to the COVID-19 pandemic: a
randomized controlled study protocol nested with a before-and-after
study including economic analysis. BMC Oral Health. 2022;22(1):112.
https://doi.org/10.1186/s12903-022-02101-9
11. Sousa DM, Souza GL, Silva CI, Castro GM. Synchronous video
with digital preservation and distributed record as a service for
telehealth. In: Proceedings of the Workshop “The Future of
Videocollaboration” – Brazilian Symposium on Multimedia and
the Web (WebMedia); 2019; Florianópolis, Brazil. Porto Alegre:
Sociedade Brasileira de Computação; 2019:175–8. https://doi.org/10.
5753/webmedia_estendido.2019.8159
12. Marchesan MTN, Ramos AG. Checklist for the development
and analysis of questionnaires in belief surveys. Lingu@gem.
2012;6(1):449–60. https://doi.org/10.14393/DL 12-v6n1a2012-23
13. Bado FMR. Translation and cross-cultural adaptation of the oral
health literacy assessment-Spanish to Brazilian Portuguese. Braz Res
Pediatr Dent Integr Clin. 2017;17(1):54–85. https://doi.org/10.4034/
PBOCI.2017.171.19
14. Adil AH, Eusufzai SZ, Kamruddin A, Muhamad W, Wan A.
Assessment of parents’ oral health literacy and its association with
caries experience of their preschool children. Children. 2020;7(8):
1–21. https://doi.org/10.3390/children7080101
15. De Buhr E, Tannen A. Parental health literacy and health knowledge,
behaviors and outcomes in children: a cross-sectional survey.
BMC Public Health. 2020;20(1):1096. https://doi.org/10.1186/
s12889-020-08881-5
16. Dieng S, Cisse D, Lombrail P, Azogui-Lévy S. Mothers’ oral health
literacy and children’s oral health status in Pikine, Senegal: a pilot
study. PLoS One. 2020;15(1):e0226876. https://doi.org/10.1371/journal.
pone.0226876
17. Buchanan H, Niven N. Validation of a Facial Image Scale to assess
child dental anxiety. Int J Paediatr Dent. 2002;12(1): 47–52. https://
doi.org/10.1046/j.0960-7439.2001.00322.x
18. Collett BR, Huebner CE, Seminario AL, Wallace E, Gray KE, Speltz
ML. Observed child and parent toothbrushing behaviors and child
oral health. Int J Paediatr Dent. 2016;26(3):184–92. https://doi.org/
10.1111/ipd.12175
Telehealth and Medicine Today © 2026, 11: 681 - https://doi.org/10.30953/thmt.v11.681 9
(page number not for citation purpose)
EHR-related technostress and work engagement
19. Llewelyn J, Addy M. A photographic method for the assessment
of examiner accuracy and variability for the scoring criteria of the
debris index. J Periodontol. 1979;50(2):84–9. https://doi.org/10.1902/
jop.1979.50.2.84
20. Rovida T. Control of dental bacterial plaque and its registration
forms. Dent Mag Araçatuba. 2010;31(2):57–62.
21. Estai M, Kanagasingam Y, Tennant M, Bunt S. Teledentistry: a
systematic review. J Dent. 2018;24(3):147–56. https://doi.org/10.
1177/1357633X16689433
22. Carrer F, Matuck B, Lucena E, Martins F, Junior G, Tricoli M, et al.
Teledontology and the Unified Health System: an important tool for
the resumption of primary health care in the context of the COVID-
19 pandemic. Bras Pediatr Dent Clin. 2020;20(1):155. https://doi.
org/10.1590/pboci.2020.155
23. Talla PK, Levin L, Glogauer M, Cable C, Allison PJ. Delivering dental
care as we emerge from the initial phase of the COVID-19 pandemic:
teledentistry and face-to-face consultations in a new clinical
world. Quintessence Int. 2020;51(8):672–7.
24. Fernández CE, Maturana CA, Coloma SI, Carrasco-Labra A,
Giacaman RA. Teledentistry and mHealth for promotion and prevention
of oral health: a systematic review and meta-analysis. J Dent Res.
2021;100(9):914–27. https://doi.org/10.1177/00220345211003828
25. Irving M, Stewart R, Spallek H, Blinkhorn A. Using teledentistry
in clinical practice as an enabler to improve access to clinical care:
a qualitative systematic review. J Telemed Telecare. 2018;24(3):129–
36. https://doi.org/10.1177/1357633X16686776
26. Tavares A, Carvalho JC, Antunes JLF. Frequency and
reinforcement in oral health education. Community Dent Health.
2020;37(4):280–6.
27. Garnett C, Crane D, West R, Brown J, Michie S. Identification of
behavior change techniques and engagement strategies to design a
smartphone app to reduce alcohol consumption using a formal consensus
method. JMIR Mhealth Uhealth. 2015;3(2):e73. https://doi.
org/10.2196/mhealth.3895
28. Giraudeau N. Digital health platforms and user engagement. Telemed
J E Health. 2021;27(7):771–8.
29. Schmalz G, Ziebolz D. Changing the focus to the whole patient instead
of one oral disease: the concept of individualized prevention. Adv
Prev Med. 2020;2020:6752342. https://doi.org/10.1155/2020/6752342
30. Bavaresco C, Gonçalves S, d’Avila BO, Umpierre R, Harzheim E,
Rodrigues JA. Remote oral health education in children. Int J Paediatr
Dent. 2021;31(5):635–42.
31. de Buhr E, Tannen A. Parental health literacy and health knowledge,
behaviours and outcomes in children: a cross-sectional survey.
BMCPublic Health. 2020;20:1096.
32. World Health Organization. Improving access to oral health services:
global policy and practice considerations. Geneva: WHO; 2022.
33. Giudice A, Barone S, Muraca D, Averta F, Diodati F, Antonelli A, et al.
Can teledentistry improve the monitoring of patients during the COVID-
19 dissemination? A descriptive pilot study. Int J Environ Res Public
Health. 2020;17(10):3399. https://doi.org/10.3390/ijerph17103399
34. Ghai S. Teledentistry during COVID-19 pandemic. Diabetes Metab
Syndr. 2020;14(5):933–5. https://doi.org/10.1016/j.dsx.2020.06.029
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Copyright (c) 2026 Marilia Goulardins Gomes, Ana Paula Dias Moreno, Fernanda de Almeida Carrer, Fernanda Souza Liévana, Mary Caroline Skelton-Macedo, Ricardo Zorzetto Nicoliello Vencio, Isabella Silva Catananti, Andiara De Rossi1 De Rossi

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