Is the answer to reducing early childhood caries in your pocket?

Electronic scientific databases Embase, CINAHL, MEDLINE, PsycINFO and Web of Science were systematically searched and restricted to articles published from 1996 onwards and limited to articles published in English. This was carried out following an initial scoping search using keywords conducted in PubMed.

Original studies investigating the use of mobile phone applications as a delivery method of healthcare interventions to parents and caregivers with children ≤6 years of age were included. As this was a mixed-methods systematic review, studies that have quantitative clinical outcomes and also qualitative outcomes of experiences, attitudes and beliefs of parents and caregivers were included. EndNote X8.2 and Rayyan.ai software was employed for title and abstract screening.

Three independent authors developed a combined data extraction tool to examine titles, abstracts and full texts of relevant articles against the inclusion criteria. The development of this tool was guided by the JBI reviewer's manual. Data extraction was completed by one reviewer, and verified by two further reviewers. Disagreements were resolved by discussion. Retrieved studies were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extracted included study reference information, study design, setting, sample sizes and intervention characteristics. A risk of bias assessment was undertaken using the Quality Appraisal for Diverse Studies tool, and a further risk assessment of quantitative and mixed methods studies.

From 5953 studies initially identified, 5 studies were included in the review. One study identified using a gamification design within a mobile health app to promote oral health had statistically significant improvements in plaque and gingival indices compared to a control group at both a 6 and 12-week recall. Two studies reported a significant improvement in maternal knowledge of children's oral health as a result of using an oral health app.

The delivery of oral health promotion through mobile health apps may be effective in reducing early childhood caries through improving health literacy in parents and caregivers, however key challenges in the app development process exist surrounding privacy issues and data protection.