Efficacy of the SMILESup mobile health intervention on oral health literacy and early childhood dental caries.

Self-reported tooth brushing habits for the child by the parent using parental self-reported questionnaire Specifically, “How often do you brush your child’s teeth with toothpaste?”

Early childhood dental caries remains a complex childhood problem that affects more than 600 million children worldwide. Our research group has previously found that in NSW currently, one in every 250 children require hospitalisation each year, with a 9% repeat admission rate within a two-year period2 for dental caries. Most of these children attend the safety-net service offered by the public health system. Improving the oral health literacy of parents remains a strong predictor that can shift the barriers to improved oral health outcomes for the child across the lifespan. The latest WHO definition on health literacy is more comprehensive and represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. When applied to the prevention of tooth decay this definition moves beyond providing a pamphlet and includes elements of motivation and empowerment related to the skills (tooth brushing) and self-efficacy required to maintain sustained preventive behaviours. Whilst, previous oral health literacy tools have focused on word recognition and understanding appointment visitations, our study will directly measure oral health literacy for behaviour change. We hypothesise that co-designed text message interventions will improve oral health literacy, self-efficacy, and behaviours (tooth brushing) of parents with children waiting for a hospital admission for dental caries more effectively than usual care. This randomised control trial, aims to co-design, assess the effectiveness, and evaluate a text message program to support oral health behaviours, increase the oral health literacy and self-efficacy of parents, compared to usual care. We also aim to evaluate fidelity, barriers, and enablers which will inform potential scale-up of the intervention.