Assessing the efficacy of short reel content on social media for enhancing oral hygiene practices among 12-year-old school-going children

1. Introduction

Oral health plays a pivotal role in overall well-being, as oral diseases not only impact eating efficiency but also have profound implications on an individual’s personality, social satisfaction, and confidence [1]. The global impact of oral diseases is extremely high, affecting approximately 3.5 billion people worldwide and imposing enormous health and economic burdens [2]. Permanent tooth caries is one of the most common health conditions globally and profoundly affects quality of life, according to the Global Burden of Disease 2017 data [3]. In India, the overall prevalence of dental caries is 54.16%, according to a study, and has been reported at 52% among specific age groups, especially 3 to 18 years old [4]. Despite being preventable, dental diseases still lead to significant public health challenges, which are largely attributed to factors such as diet and lifestyle modifications. Thus, there is a critical need for holistic guidance, especially at early developmental stages, to facilitate the implementation of effective lifestyles and practices to prevent oral diseases [5].

During adolescence, typically between the ages of 12 and 14 years, cognitive functions are fully developed. This makes it a critical period for behavior modification to instill lifelong self-care habits [6]. At 12 years, children are typically finishing their primary education, making it a very good time to collect the data. Moreover, as all permanent teeth except for the third molars have erupted by this age, it is an optimal period for universal comparison of dental disease types [7]. Indian schoolchildren often experience comorbidity with dental diseases, resulting in high treatment costs. Thus, prevention is considered the most promising method used to combat oral health problems [8]. However, India struggles to achieve this due to disparities in the healthcare system, which is even more limited in rural areas, where a majority of the population resides, with over 40% being children under 15 years old [9, 10].

Social media, a culmination of internet-based applications stemming from Web 2.0, empowers individuals to generate and distribute their own content [11, 12]. Recent years have seen an explosion in the popularity of virtual media as an effective communication tool for exchanging information and ideas [13, 14, 15, 16, 17]. Digital media usage in India has surged with an estimated 600 million active internet users. Starting from simple email messaging, internet usage today covers an array of online platforms such as WhatsApp, YouTube, Instagram, Facebook, Messenger, and Twitter, which have smoothly integrated into the daily lives of many Indians [18]. This pattern extends to dentistry, where young dentists increasingly use social networking applications to promote oral health [19]. Acknowledging the opportunities of digital media in terms of their ability to reach large audiences, especially in remote regions where oral health services are less accessible, is imperative, given the close association between poor oral health and systemic health issues. Consequently, advocating and adopting healthy practices, especially from a young age, is paramount. Hence, the present study aims to assess the efficacy of short reel content on social media in enhancing oral hygiene practices among 12-year-old school-going children.

2. Materials and methods

A quasi-experimental study design was adopted to assess the efficacy of short reel content on social media for enhancing oral hygiene practices among 12-year-old school-going children. Ethical approval was obtained from the Institutional Ethical Committee of the People’s College of Dental Sciences and Research Centre (EC202179). The study was conducted over four months, between May 2023 and August 2023. The study protocol was developed, and all subjects/parents/caregivers provided written informed consent before participation. Participants were randomly assigned to either the intervention group (exposed to short-reel content on oral hygiene) or the control group (not exposed to short-reel content). The intervention group received access to short-film content on social media platforms focused on oral hygiene practices. The content included educational videos, animations, and interactive quizzes aimed at promoting oral health habits. Table 1 presents a detailed description of the educational intervention. The control group did not receive any intervention and continued their usual oral hygiene routines.

Intervention group inclusion criteria were: (i) students aged 12 years; (ii) students willing to participate; and (iii) students who were able to effectively communicate. Exclusion eligibility criteria included students with systemic diseases, students on medication, and students unwilling to participate. It also excluded children with significant cognitive or physical impairments that could prevent effective engagement.

With 80% power and 5% level of significance, we determined the desired sample size (n = 136) for each group, for a total of 272 participants. To account for an expected 20% sample loss on follow-ups, the sample size was increased to 324 participants. A final sample size of 380 was calculated to ensure that the full stratum of 12-year-olds in the selected schools, including 190 individuals from each group, resulted in a more complete representation of participants from the target age group. Therefore, the final sample size (380 participants, evenly split between the intervention and control groups) was considered essential to properly evaluate the effect of the intervention on improving oral hygiene practices of school-going children aged 12 years. A stratified random sampling technique was employed to recruit the study sample. The study selected one school from each administrative zone (North, East, West, South, and Central) of Bhopal city.

3. Results

Among the 380 students included in the study, there were 189 males and 191 females. The assessment of students’ knowledge and attitudes toward oral health revealed that 58.1% recognized how to detect tooth decay or cavities; 83.1% were aware that yellow or brown discoloration near the tooth and gum indicated unhealthy teeth; 59.2% understood that fluoride helps prevent tooth decay; and 74.2% knew that mouthwashes can prevent or reduce gum problems (Table 2).

In terms of attitudes, 86.5% and 73.1% of students acknowledged the importance of oral health and caring for teeth and gums, respectively. However, only 4.2% believed that dental treatment was affordable, while 68.1% experienced anxiety about visiting a dentist, and only 4.7% recognized the necessity of biannual dental visits (Table 2).

Assessment of students’ oral hygiene practices (Table 3) revealed that only 20.5% brushed their teeth twice daily, 15.7% utilized additional cleaning measures such as dental floss and tongue cleaners, 25.7% used medium-hard brushes, and 12.6% replaced their brushes every three months. Additionally, 19.7% and 18.1% of students reported occasional consumption of sweets and carbonated drinks, respectively, while only 13.6% rinsed their mouths with water after eating, and 21.3% visited a dentist regularly.

As shown in Table 4, following the intervention, the intervention group significantly improved their knowledge, attitudes, and oral hygiene practices compared to the non-intervention group.

The oral hygiene index simplified mean value decreased to 1.171 ± 0.552 in the intervention group and 2.35 ± 3.71 in the control group post-intervention, with a statistically significant difference noted (Table 5). The mean value of the simplified oral hygiene index before and after intervention in the experimental group was 2.570 ± 1.618 and 1.171 ± 0.552, while in the control group it was 2.590 ± 0.824 and 2.356 ± 3.717, respectively (Table 5). The intervention significantly improved the oral hygiene index in the experimental group, but not in the control group. The experimental group showed a strong intervention effect with a higher effect size, indicating the effectiveness of the educational intervention in improving oral hygiene practices.

The study findings suggest that there is a notable gap in oral health knowledge, attitudes, and practices among school-going children. Prior to the intervention, a significant proportion of students demonstrated a limited understanding of oral health concepts and exhibited suboptimal oral hygiene practices. However, following the intervention, there was a marked improvement in knowledge, attitudes, and practices related to oral health among the intervention group compared to the control group. Specifically, there was increased awareness regarding tooth decay, the importance of oral health, and the need for regular dental visits. Moreover, the intervention group showed a significant enhancement in oral hygiene practices, as evidenced by a lower mean value of the simplified oral hygiene index compared to the control group.

4. Discussion

With the widespread availability of computers and mobile phones in households, children now have easier access to the internet, which has increased influence of social media platforms, especially among younger populations. This trend has grown significantly over recent decades, allowing individuals to access a wealth of health-related information published by both public and private sources [22]. Recognizing this as a valuable opportunity, the present study aimed to evaluate the effectiveness of short-reel content on social media in enhancing oral hygiene practices among 12-year-old school-going children. The study found that students’ knowledge, attitudes, and oral health practices were suboptimal, indicating significant room for improvement in their approach to oral health. However, after the intervention using short-reel content, there was a marked improvement in awareness, attitudes, and oral hygiene practices compared to the control group, which received only chair-side educational talks.

This study suggests that social media has a significant visual impact on memory and behaviour change among students, particularly when compared to traditional educational methods. Previous studies have also shown that oral health interventions on virtual platforms improve participants’ knowledge, attitudes, and practices. Such interventions generally show satisfactory acceptability and retention rates and have significant potential, and social media may therefore be an effective medium for promoting oral health education in schoolchildren [23].

In this study, approximately 77.8% of students initially reported using the internet to seek information on oral healthcare. Althunayan et al. [24] reported that 64% of participants used social media to access oral health updates, highlighting the potential of social media to shape oral health behaviours. The widespread use of virtual platforms for health information seeking is partly due to their easy accessibility and high public acceptability. Social media can enhance children’s learning outcomes in oral health interventions and promote adherence to recommended oral hygiene practices, as demonstrated by the current study. This finding aligns with several other studies showing that technologies, such as oral health videos on different social networking sites, text-messaging reminders, and WhatsApp messages, can improve knowledge, attitudes, and oral health practices [25, 26, 27, 28].

In the present study, the mean OHI-S score before the intervention was 2.57 ± 1.61 in the experimental group and 2.59 ± 0.82 in the control group, indicating a fair oral hygiene status among students. Similar findings were reported by Sukhabogi JR et al. [29], who observed a mean OHI-S index of 2.8 ± 1.1 among students, also reflecting a fair oral hygiene status.

Following the intervention in our study, the OHI-S score significantly improved in the experimental group compared to the control group. This trend is consistent with the results of Dientyah Nur Anggina et al. [19], who reported a significant reduction in OHI-S score among adolescents receiving social media-mediated oral health intervention. Lopes Dos Santos R et al. [30] showed that mobile applications can lead to oral hygiene improvement in adolescents. Collectively, these insights underscore the impact of interactive digital interventions disseminated through diverse social media platforms on knowledge, attitude, behavior, and overall oral health. In countries such as India, where oral health diseases are highly prevalent among children and access to oral health services is variable, preventive measures are vital to reducing the burden of oral health problems.

The restricted geographical area of the sample may limit the generalizability of the findings to broader populations of school-going children. Additional studies using larger samples with a more varied sample could provide broader insight into the effectiveness of short-film content on social media in promoting oral hygiene behavior. The duration of follow-up was rather brief in the current study. Longer-term follow-up could be employed to assess the persistence of improvements in oral hygiene practices. This study was based solely on self-reported data from participants, which may be susceptible to recall bias or social desirability bias. In the future, objective or observational methods might be used to confirm self-reported oral hygiene practice. The control group in this study received chair-side educational talks, which may have influenced their oral hygiene practices independently of the intervention. Comparing the short-reel content intervention with a true no-intervention control group could provide more robust evidence of its efficacy.

5. Conclusions

The current study found that short reel content significantly enhanced students’ knowledge, attitude, oral hygiene practices following the intervention. Before the intervention, students were already heavily utilizing the internet through various social media platforms, primarily due to its quick access and lack of time constraints. Short reels focus on delivering concise information through innovative content, which significantly enhances children’s memory retention. If used wisely, social media can influence behavior modification and promote healthy lifestyles among 12-year-old schoolchildren. This study recommends utilizing these findings to establish successful oral health programs and achieve desired health benefits for children, as good oral health is an essential component of overall health and well-being.

Availability of data and materials

The data will be available on reasonable request from the corresponding author.

Author contributions

SABH, SaS—conceptualization; formal analysis. ABMA, SUK, ShS—methodology; data curation. MDB, MC—software. SaS—investigation. MDB, GM—writing–original draft preparation. MC, GM—writing, review, and editing. GM—supervision; funding acquisition. MC—administration. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of the People’s College of Dental Sciences and Research Centre, Bhopal, India (Approval Number: EC202179). Informed consent was obtained from all participants and their caregivers prior to study enrollment.

Acknowledgment

The authors would like to thank Luis Eduardo Almeida, a native English speaker at the Department of Surgical Sciences, School of Dentistry, Marquette University, Milwaukee, Wisconsin, USA, for reviewing and editing the manuscript to ensure proper scientific English. Moreover, the authors would like to acknowledge Mario Fordellone, a professional statistician, who reviewed the statistical analysis of this paper.

During the preparation of this manuscript, the authors used DeepL Translate for language checking/grammar correction. After its use, the authors thoroughly reviewed, verified, and revised all content to ensure accuracy and originality. The authors take full responsibility for the integrity and final content of the published article.

Funding

This research received no external funding.

Conflict of interest

The authors declare no conflict of interest. Giuseppe Minervini was a member of the Editorial Board of this journal at the time of submission We declare that Giuseppe Minervini had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to JEN.

Supplementary material

Supplementary material associated with this article can be found in the online version, at https://oss.jocpd.com/files/article/2095394016465960960/attachment/Supplementary%20material.docx.