Evaluation of a school-based brushing programme using a smart toothbrush

INTERVENTION: All participating children will receive a smart, electric toothbrush to use each day at home (morning and bedtime). The smart, electric brush captures information on coverage, duration and frequency of brushing commuting these data to children while they brush via an accompanying app. Apart from the brush, teachers will have access to a brief, class‐level dashboard where they can see how their class is doing (in comparison with other classes) and set challenges for the children to help them achieve better goals (or maintain good practices if they do well). Finally, a subset of children will be assigned text message support (delivered to their parents' mobile phones). Text messages will contain messages directed at parents and children to emphasize key messages and to motivate them to continue using the brush. All intervention elements will be delivered for 3 months (follow‐up period). Brushes will be used at home directly by children with parental supervision. Teachers will receive access to the weekly dashboard on Monday each week. On school closures (Easter, Summer break, half‐term etc) no dashboard will be provided. In the text message subgroup, parents will receive messages in a tapered approach with more text messages at the start and less towards the end of the study. In total, each parent will receive nine text messages over the course of the study. Allocation on treatment arms will be at the school level (simple randomisation [flipping a coin]) with participating schools receiving either the connected brush and text messages or receiving only the connected brush. CONDITION: Improving oral hygiene practices in primary school children in underserved areas of Manchester ; Oral Health PRIMARY OUTCOME: Feasibility of using a smart, electric brush by children, assessed using:; 1. Consent rate recorded as the number of participants consented at 2 weeks following the initial approach by the study team; 2. Recruitment rate recorded as the number of participants who completed at least one of the study surveys post‐consent (post‐baseline); 3. Recruitment pathways for future studies recorded as the number of new sites (first time involved in research studies) taking part in the study; 4. Acceptability of the interventions on schools and parents recorded at follow‐up through surveys and brief feedback interviews SECONDARY OUTCOME: 1. Knowledge, attitudes and practices regarding oral health measures by a KAPs questionnaire at baseline and end of follow‐up; 2. Oral hygiene practices measured by a brief oral hygiene survey at baseline, 1‐week, 1‐month, 2‐month and 3‐month follow‐up INCLUSION CRITERIA: 1. Children enrolled and attending primary schools in Greater Manchester aged 8 to 11 years 2. Participants must have WIFI in their home and a smart device that is compatible with the toothbrush and app. Access to Apple iPhone (newer than 8) or iPad (newer than 5th generation) or Android users (running Android 6.0 and up) with access to an Internet connection 3. Not having previously used the smart, electric brush that is distributed during the study