Impact of Virtual Supervised Tooth Brushing on Caries Experience and Quality of Life among Primary School Children: Study Protocol for a Randomised Controlled Trial

Abstract

Background Dental caries is one of the most common diseases afflicting children in the Kingdom of Saudi Arabia. Supervised toothbrushing programs are implemented throughout the world to provide young children's developing teeth with additional fluoride as a form of dental caries prevention. While school-based supervised toothbrushing programs have been proven to improve young children's oral health, virtual supervised teeth brushing programs have not been assessed. The purpose of this protocol is to assess the impact of virtual supervised toothbrushing on caries experience and quality of life among primary school students in Riyadh, Saudi Arabia. Methods This is a cluster randomized controlled trial comparing virtual supervised tooth brushing program against no intervention applied. A total of 1,092 (546 in each group) children in Riyadh primary schools, Saudi Arabia will be recruited to the trial. Schools (cluster) will be randomly selected and allocated to either group. Clinical assessment for caries experience will be conducted in four points (baseline, + 3 months, + 6 months, + 12 months) by dental hygienist using World Health Organization criteria. Data on socio-demographic behavioural factors and children’s quality of life will be collected with every clinical assessment through a structured questionnaire. The primary outcome is the change in caries experience (the number of teeth with untreated dental caries, filled and missing teeth) in both primary and permanent teeth over 12 months. The secondary outcomes are the change in the frequency of brushing per day and the impact of oral health on the child’s daily life (QoL). Discussion Teaching in schools is carried out virtually in Saudi Arabia and with an effective IT infrastructure in place. Virtual supervised tooth brushing is a proposed initiative. It is also an opportunity for targeting a large portion of the population with a high level of disease as a quarter of the Saudi population is younger than 15 years. This project should provide high level evidence on the effectiveness of virtual supervised toothbrushing. The findings should potentially inform policies related to the continuation/implementation of school-based programs in Saudi Arabia. Trial registration: ClinicalTrials.gov, ID: NCT05217316. Registered on 19 January 2022.