BackgroundOral self-care plays an important role in maintaining oral health and preventing the occurrence of oral diseases. The association between good oral care and good oral hygiene is well known. However, the adherence to a proper daily oral hygiene regimen generally remains poor, so the prevalence of oral diseases remains high. Periodontal disease is the most common oral disease in the population. To enhance the adherence to good oral hygiene behaviors for patients with periodontal disease, we developed a personalized and evidence-based mobile application as an intervention tool for the purpose of initiating and improving good oral self-care.ObjectiveThe objective of this study was to demonstrate the systematic development process and content of the oral self-care mobile application, OSCA.MethodsThe systematic development process of OSCA consists of three phases: behavioral diagnosis, intervention design, and assessment of OSCA. Firstly, behavioral problem of oral self-care was identified by the experts in periodontics care. Secondly, the intervention functions and the mode of delivery were designed based on the capability-opportunity-motivation behavioral model, which is the underpinning model behind the behavior change wheel framework. Thirdly, the developed app was evaluated by the experts through a heuristics evaluation checklist by adopting Morville’s Honeycomb model, and the final version of OSCA was assessed by the patients with periodontal disease using the System Usability Scale (SUS).ResultsThe problems of target behavior were identified and incorporated into the design of intervention functions. For the beta version of the OSCA, experts proposed four main suggestions to improve the usefulness. Experts evaluated the beta and final versions of the app using a heuristics evaluation checklist, providing mean scores of 4.38 and 4.62, respectively. For usability testing, 87 participants completed both the specified tasks and the SUS questionnaire, providing an SUS median score of 77.5 (IQR = 12.5) and an overall mean completion time of 12.22 minutes for the specified tasks. The mean scores of the intervention functions for capability establishment, motivation enhancement, and opportunity creation were 6.13, 5.88, and 6.06, respectively.ConclusionsThe study presents a rigorous design process of developing an evidence-based and personalized mobile application for oral self-care. The results of the expert evaluation confirmed the validated design and the participants were satisfied with the designed app.

Good oral hygiene is essential to oral health and oral disease prevention. Strengthening the adherence of patients with periodontitis to oral hygiene behaviors (OHBs) is crucial for the success of periodontal treatment. This study aims to investigate the intervention effectiveness of a novel mobile app for precision oral self-care, which was developed to help patients with periodontitis improving their oral hygiene through daily oral self-care. One-hundred and fifty eligible patients were recruited into this study and randomly allocated to the control (n = 75) or intervention group (n = 75), and their oral hygiene status (OHS) and OHBs were recorded at baseline and re-evaluation. The participants in the intervention group were required to perform daily oral self-care using our oral self-care app (OSCA) and the functional preferences and overall likeability of the OSCA were evaluated through a questionnaire survey. In total, 39 patients from the control group and 49 from the intervention group completed clinical examinations at baseline and re-evaluation. The results demonstrated that there was no significant difference in OHS improvement between the two groups. However, OHS improvement significantly differed between low-, moderate-, and high-frequency users, with frequency of use being positively correlated to the likeability of the app. Further investigation of the effectiveness of the OSCA intervention revealed that behavioral change in oral hygiene, frequency of OSCA use, and smoking affected OHS improvement. These outcomes indicate that our app-based mobile intervention may be of value for precision oral self-care in patients with periodontitis.