Effectiveness of a Mobile Application ‘Gigiku Sihat’ in Improving Oral Hygiene of Pre-school Children in Kelantan: A Randomized Control Trial

Abstract

Introduction: The use of mobile health (mHealth) applications has become an effective approach for enhancing public health. While many oral health-related mobile apps are now available, there is limited information on the efficacy of apps developed locally. This study aimed to assess the impact of the ‘Gigiku Sihat’ mobile application on improving oral hygiene among pre-school children. Methods: This was a non-inferiority, parallel, two-group cluster randomised controlled trial involving 10 KEMAS pre-schools in Tumpat, Kelantan. The pre-schools were randomly assigned to the study group (SG) or control group (CG) using block randomisation. Parents or guardians of children aged 4 to 6 years in the SG received conventional oral health education alongside the ‘Gigiku Sihat’ app, while the CG only received conventional oral health education. Random assignment was computer-generated, and allocation concealment was maintained until the study’s conclusion. Participants, including pre-schools, children, and parents, were unaware of their group allocation until after the baseline data were collected. The primary outcome measure was the Simplified Oral Hygiene Index (OHI-S) at baseline, 6 weeks (Evaluation 1), and 12 weeks (Evaluation 2) after the intervention. Descriptive analysis, repeated measures ANOVA (RM-ANOVA), and independent t-tests were applied, with statistical significance set at p<0.05. Results: A total of 120 children aged 4 to 6 years and their parents or guardians participated, with 60 parent-child pair in each group. Of these, 115 parent-child pairs completed the study. At baseline, the mean OHI-S scores for SG and CG were 1.3 (95% CI 1.12, 1.48) and 1.2 (95% CI 1.04, 1.36), respectively. At 6 weeks, the SG showed a reduction in OHI-S scores to 1.1 (95% CI 0.94, 1.28), whereas the CG’s scores increased to 1.3 (95% CI 1.13, 1.15). At 12 weeks, significant reductions were observed in both groups (SG = 0.6, 95% CI 0.43, 0.71; CG = 0.9, 95% CI 0.76, 1.03; p<0.05), with a significantly lower OHI-S score in the SG compared to the CG. Conclusion: The combination of the ‘Gigiku Sihat’ app and conventional oral health education was more effective in improving the oral hygiene of pre-school children at the 12-week evaluation compared to conventional methods alone.