Personalized Digital Coaching for Oral Hygiene Adherence: Randomized Controlled Trial.

The goal of this clinical trial is to learn if a personalized Digital Oral Health Intervention (DOHI) improves how well adults follow recommended tooth brushing routines. Researchers also aim to understand which factors influence the success of the intervention. The main questions this study will answer are: Does using the DOHI lead participants to brush twice daily for two minutes, covering all four quadrants (the 2x2x4 routine) more consistently than traditional oral hygiene instructions alone? Which participant characteristics, such as demographics or baseline oral hygiene habits, affect how well the DOHI helps people improve their brushing? How does engagement with the digital coaching and technology impact adherence to recommended oral hygiene practices? In this study: 230 adults receiving care at community dental clinics in California will participate. Everyone will begin with a 2-week run-in period using traditional oral care instructions. Afterward, participants will be randomly assigned to one of two groups: The control group will continue with traditional oral hygiene instructions. The intervention group will receive traditional oral hygiene instructions plus personalized digital coaching delivered through a mobile app and an electronic toothbrush system. The DOHI provides personalized feedback, educational content, and motivational prompts that adapt over time based on each participant's brushing behavior and engagement. Both groups will use an electronic toothbrush to objectively record when, how long, and how well they brush. Participants will: Follow the assigned oral hygiene instructions for 19 weeks. Use an electronic toothbrush and mobile app as instructed. Have their brushing data automatically collected and analyzed by researchers. The study will look at changes in brushing frequency and duration from before to after the intervention. Researchers will also explore how personal characteristics and engagement with technology influence outcomes. The results of this trial will help community dental clinics know if personalized, digital coaching can help more adults maintain healthy habits and achieve better oral health, and guide future improvements in digital health interventions for oral hygiene.