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The goal of this cluster-randomised control trial is to assess the effectiveness of the MySmile app for improving oral health in secondary school children. The main questions it aims to answer are:
Participants in the intervention group will receive the SDS and MySmile app. The control group will receive SDS only. Therefore the researcher will compare between the intervention and control group in terms of dental plaque, gingival health, oral health knowledge, oral health attitudes and oral health behaviours.
The selection of schools into the study will involve three (3) sampling levels. At the first level, acknowledging the division of secondary schools in the district into urban and rural, one matched-pair will be randomly selected from urban area, and another matched pair will be randomly selected from rural area. At the second level, randomisation of the school is carried out. The 2 schools in each of the matched-pair will be randomly allocated to intervention and control group. At the third level, six (6) classrooms from moderate academic performance level will be selected (2 classrooms from Form 3, Form 4, and Form 5, respectively). Students who fulfil the inclusion criteria will be invited to participate in the study. The randomisation sequence will be carried out by the statistician at the Faculty of Dentistry, Universiti Malaya
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | Participants in this group will get the School Dental Service and MySmile App. |
|
| Control Group | Active Comparator | Participants in this group will get the School Dental Service only |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MySmile app | Other | The MySmile app contains several features: A) Knowledge Hub
B) Track yourself Brushing diary Diet diary C) Get help
|
| Measure | Description | Time Frame |
|---|---|---|
| The mean decrement in plaque score will be assessed using the Plaque Control Record developed by O'Leary Drake and Naylor in 1972 | The mean decrement in plaque score from baseline to follow-up between the intervention and control group will be assessed. For this test, the plaque is disclosed using a two-tone disclosing agent. The great advantage of the two-tone effect is that it can differentiate a new and matured plaque. The presence (+) or absence (-) of plaque is recorded in a chart, and the plaque incidence in the oral cavity will be expressed as a percentage (%). To determine the plaque index of an individual, the total number of surfaces with plaque will be divided into the number of available surfaces times by 100. The mean decrement score is obtained by subtracting the mean score at follow-up from the mean score at baseline. Finally, the mean decrement scores of the intervention and control groups are compared. | after 4 weeks and 12 weeks post-intervention |
| The mean increment in gingival health will be assessed using Gingival Index developed by Silness and Loe in 1963 | For the selection of tooth, six (6) index teeth will be used. Each tooth will be assessed by scoring 0 = normal gingiva, 1 = Mild inflammation- a slight change in colour and slight oedema. No bleeding on probing, 2 = Moderate inflammation. Redness, oedema and glazing. Bleeding on probing, 3 = Severe inflammation, marked redness and ulceration and tendency toward spontaneous bleeding. To calculate the index tooth score, the score for each four (4) scoring unit is summed up and divided into 4. To calculate the Gingival Index for the entire assessment, sum up the scores for all index teeth and then divide by six (total index teeth). This will provide an overall index score for the patient's gingival health. The mean increment score is obtained by subtracting the mean score at follow-up from the mean score at baseline. Finally, the mean increment scores of the intervention and control groups are compared. | after 4 weeks and 12 weeks post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| The mean increment of oral health knowledge, attitude and practice using validated questionnaires. | It consists of 3 domains; (a)The Oral Health Knowledge domain(16 items). Each item is assessed by 1 correct answer from 3 options. Total score = sum scores of correct answers with a score range from 0-16; (b) Oral Health Attitude domain will have 4 subdomains (21 items). Each item is assessed using a 4-point Likert scale (strongly disagree to strongly agree). Total score = sum scores of all items with a score range from 0-21; (c) For the Oral Health Behaviour domain (8 items). Answers are analysed accordingly into 'good' and "less good' OHB. Next, a score of 1 will be given for an item with 'good' behaviour and a score of 0 for an item with "less good' behaviour. The percentage score for Oral Health Behaviour will be calculated by adding all the items, dividing by 8, and times 100. Mean increment scores of 3 domains are calculated by subtracting the respective scores at baseline from follow-up scores. The mean scores were compared between the intervention and control groups. |
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Inclusion criteria for school
Inclusion criteria for the participants:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Muhammad Hamidie Saari, Master | Contact | 0176312109 | meedie89@gmail.com | |
| Zamros Yuzadi Mohd Yusof | Contact | 03-79674805 | zamros@um.edu.my |
| Name | Affiliation | Role |
|---|---|---|
| Zamros Yuzadi Mohd Yusof, PHD | Faculty of Dentistry, Universiti Malaya | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Muhammad Hamidie bin Saari | Kuala Lumpur | Wilayah Persukutuan Kuala Lumpur | 50480 | Malaysia |
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| ID | Term |
|---|---|
| D009059 | Mouth Diseases |
| D005882 | Gingival Diseases |
| ID | Term |
|---|---|
| D009057 | Stomatognathic Diseases |
| D010510 | Periodontal Diseases |
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| Control | Other | This will receive the usual School Dental Service. School Dental Service provide students who need dental treatment and will be called to be given treatment. Among the treatments given include:
All treatment is free of charge except for dentures, crown/bridge work and orthodontics. Treatment for school children is based on normative needs assessment as determined by the dentist. A child is defined as orally fit when all required treatment in the SDS has been completed and appropriate oral hygiene status is maintained. |
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| after 4 weeks and 12 weeks post-intervention. |