894 D3000 new imprint Word template Vol 13, No 1 (2025) ISSN 2167-8677 (online) DOI 10.5195/d3000/2025.894 http://dentistry3000.pitt.edu Effect of Smartphone Application Reminder on Improving Oral Hy- giene Ali Hadi Fahad College of Den*stry, University of Kufa, Iraq Abstract Objec/ve: To study the effect of smartphone applica/on reminder on improving oral hy- gine among male students from University of Kufa. Materials and Methods: In this prospec/ve study, 120 students age ranging from 18 to 24 years were separated into two groups. All par/cipants received a clinical examina/on and a ques/onnaire. ANer receiving typical oral hygiene instruc/ons, par/cipants in the study group were instructed to u/lize the Brush DJ smartphone applica/on and were compared to par/cipants in the other group who got conven/onal oral hygiene instruc/ons. Note that the two groups received same toothbrushes and toothpastes. The measurement of plaque and gingival index was done on three visits. Results: Independent of the group, par/cipants improved from the first to the third meas- urements for both plaque and gingival index. Conclusion: Smartphone applica/ons might significantly improve the oral hygiene compli- ance of students, by ac/ng as reminders and mo/vators. Open Access Cita%on: Fahad AH (2025) Effect of Smartphone Applica- %on Reminder on Improving Oral Hygiene. Den%stry 3000. 1:a001 doi:10.5195/d3000.2025.894 Received: March 31, 2025 Accepted: May 20, 2025 Published: June 27, 2025 Copyright: ©2025 Fahad AH. This is an open access ar%- cle licensed under a Crea%ve Commons AWribu%on Work 4.0 United States License. Email: alih.fahad@uokufa.edu.iq Introduc)on Gingivitis linked to plaque accumulations, hormonal shifts, drugs, systemic ailments, and malnutrition has distinct traits. These in- clude localized in=lammation in the free and attached gingiva, reversible with bio=ilm dis- ruption, and high bacterial plaque levels trig- gering or worsening the condition [1,2]. Maintaining optimal oral hygiene is impera- tive for overall health and well-being. Poor oral health not only leads to various dental ailments such as caries, periodontal dis- eases, and halitosis but also has systemic im- plications, including cardiovascular dis- eases, diabetes, and adverse pregnancy out- comes. Among university students, espe- cially males, oral health tends to be over- looked due to hectic academic schedules, irregular lifestyles, and inadequate aware- ness regarding oral hygiene practice [3]. Oral cleanliness is crucial for oral health, re- moving microbial plaque and preventing its buildup on teeth and gums. Ideal plaque con- trol through daily toothbrushing and inter- dental plaque removal every 24 hours is suf- =icient to prevent gingivitis and inter-dental caries [4,5]. Various inter-dental cleaning devices are available, posing challenges for both patients and dental professionals in se- lecting the right one. An ideal device should be easy to use, remove plaque effectively, and cause no harm to oral tissues [6]. Despite the widespread availability of dental health education, adherence to recom- mended oral hygiene behaviors remains a challenge for many individuals. This discrep- ancy underscores the necessity for innovative interventions that can effectively promote sustained oral care habits. In this context, smartphone applications present a promising avenue, leveraging ubiquitous technology to deliver personalized remind- ers and educational content tailored to indi- vidual oral health need [7]. In recent years, the proliferation of smartphone technology has fundamentally transformed various aspects of our daily lives, including healthcare management. Among the myriad of applications, those aimed at improving health behaviors have garnered substantial attention, particularly in the domain of oral hygiene. The oral cavity serves as a gateway to overall health, with in- adequate oral care linked to a spectrum of systemic diseases, ranging from cardiovas- cular disorders to diabetes. Consequently, Effect of Smartphone ApplicaIon Reminder on Improving Oral Hygiene Vol 13, No 1 (2025) DOI 10.5195/d3000/2025.894 http://dentistry3000.pitt.edu 2 optimizing oral hygiene practices emerges as a pivotal preventive strategy to mitigate these health risks [8]. With the advent of digital technology, smartphone applications have emerged as promising tools for promoting health behav- iors, including oral hygiene practices. There are applications for educating and encourag- ing youngsters and adults to use additional oral hygiene products and proper teeth brushing techniques [9,10]. These applications offer personalized re- minders, educational resources, and track- ing features, which can potentially empower individuals to adopt and sustain healthy hab- its. However, despite the growing popularity of such applications, there remains a paucity of scienti=ic literature evaluating their ef=i- cacy, particularly among speci=ic de- mographics such as male university stu- dents [11]. Owing to half of the healthcare practitioners having smart phones use apps in their day- to-day practice, there are wide range of healthcare apps providing extensive infor- mation to support clinical decision-making and better patient care. Today, healthcare apps have better usage comparing any other source of information and bene=itted healthcare professionals due to quicker ac- cess to information [12,13]. The University of Kufa, situated in Najaf, Iraq, represents a unique setting for studying oral hygiene practices among male students. With a diverse student population and vary- ing socioeconomic backgrounds, the univer- sity provides an ideal environment to inves- tigate the effectiveness of smartphone appli- cation reminders in improving oral health behaviors. Understanding the impact of these interventions is not only crucial for the well-being of the students but also has broader implications for public health initia- tives in similar educational settings. Material and Methods Study Design and Setting Blinded, parallel group, non-strati=ied ran- domization and equal allocation ratio (1:1) were used in this prospective study. The study was carried out in Faculty of Nursing and Faculty of Science, University of Kufa at Al-Najaf city. Ethical approval was obtained from the Local Ethical Committee, the Col- lege of Dentistry at University of Kufa (Refer- ence number 745). Informed consent and as- sent were obtained from the students them- selves. The study adhered to the principles of the Declaration of Helsinki. Participants A total of 120 subjects were randomly di- vided into two groups. In the =irst, a ques- tionnaire containing 10 questions about oral health care was distributed to the two groups. Study group received toothbrush, toothpaste, and reminder application about oral hygiene. The other group received toothbrush, toothpaste, and oral hygiene in- structions only without reminder applica- tion. Users could set reminders to brush twice a day, however, this App can be used as reminder to attend the next dentist/hygien- ist/therapist visit. The application also in- cludes links to illustrated YouTube videos that show ways to use dental =loss, an inter- dental brush and a traditional toothbrush. Data Collection Collection of data was performed by cali- brated examiners. Clinical examinations were conducted in a standardized manner, using a dental mirror and a periodontal probe (WHO probe) under adequate light- ing by dental chair light. Oral Hygiene Assessment Oral hygiene status evaluated by application plaque index (Pl) of Silness and Löe [14], and gingival in=lammation assessed by using Gin- gival Index (GI) of Löe and Silness [15]. Statistical Analysis Statistical analyses were done using SPSS 23 version 21 computer software (Statistical Package for Social Sciences) in association with Microsoft Excel 2013. Frequency distri- bution for selected variables was done =irst. The statistical signi=icance, by using Descrip- tion of Statistics, median, mean rank, chi- square for statistical differences. P value less than the 0.05 level of signi=icance was con- sidered statistically signi=icant. Results Percentage of participants who brushed once daily was 42.5%, not everyday was 37,5% and twice or more was 20%. For median of PI among study group, the higher median value was (1.33) found with the =irst exam, while the lower median value was (1.04) found with third exam. For the comparison group, the higher me- dian value was (1.54) found with third exam, while the lower median value was (1.048) found with second exam. There were no statistically signi=icant differ- ences between the two groups. Discussion This App was selected in the present study to test the improvement of the oral health and creating a new positive habit for people. The ef=iciency of this App was studied by [16,17] who found that there was a positive correla- tion between App usage with the brushing duration and frequency, hence, its ef=icacy in improving oral health. Ben Underwod (2018) stated that ”If you want to make peo- ple do something, you have to make it fun" [18,19]. A one year later, he was honored by the British Society of Pediatric Dentistry 4s Outstanding Innovation for his innovation of this App transferring his concept to a reality. In the present study, the median plaque in- dex of study group highly signi=icantly re- duced from the baseline to 3 months after use the application. The reduction of PI agrees with other studies used smartphone App as |20,21]. For the control group, it showed slight increase in the median plaque index over time without signi=icant differ- ences. These results are like a recent study that found [21]. Signi=icant differences in PI were noted between the two groups (study and control) after 3 months from the =irst ex- amination show positive effect of application to improve oral health. According to this research, the median gingi- val index of study group highly signi=icantly reduced after use the application. This result was in line with other studies showed a rela- tion between the effect of application and improve oral hygiene [22]. On the other hand, the median GI of control group, it shows slight increase in the median plaque index over time without signi=icant differ- ences. 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