Effect of mHealth Intervention on Oral Health-Related Quality of Life Among Adult Patients With Chronic Systemic Diseases

This pragmatic quasi-experimental study was conducted among adult patients registered in four specialized disease centers in Al-Ahsa, Saudi Arabia: the Endocrinology and Diabetes Center, Prince Sultan Center for Cardiac Diseases and Surgery, Al-Jaber Kidney Center, and Hereditary Blood Diseases Center. The study population included adults with type 1 diabetes mellitus, cardiovascular disease, chronic kidney disease, or hereditary blood disorders.

Eligible participants provided electronic informed consent before participation. Following baseline assessment, participants were assigned to parallel intervention and control groups. The intervention lasted 3 months, with assessments conducted at baseline (T0), 1 month (T1), and 3 months (T2).

Participants in both groups continued their routine health care. The control group received a standardized printed oral health education leaflet containing recommendations for daily home oral care. In addition to routine care, the intervention group received five Arabic educational videos addressing toothbrush and fluoride toothpaste selection, toothbrushing technique, dental flossing, tongue cleaning, and water flosser use. The intervention was delivered through a secure web-based platform, and access links were sent through WhatsApp. The educational package was re-sent every 2 weeks during the intervention period to reinforce exposure to the educational content.

Oral health-related quality of life was measured using the validated Arabic version of the 14-item Oral Health Impact Profile (OHIP-14). Assessments were completed at baseline, 1 month, and 3 months. The principal comparison focused on differences between the intervention and control groups in change in total OHIP-14 score from baseline to the 3-month assessment. Additional analyses examined OHIP-14 over the study period and its relationship with selected participant characteristics.

Inclusion criteria

• Aged 18 years or older.
• Registered at one of the participating specialized disease centers in Al-Ahsa, Saudi Arabia.
• Physician-confirmed diagnosis of type 1 diabetes mellitus, cardiovascular disease, chronic kidney disease, or a hereditary blood disorder.
• Medically stable at the time of enrollment.
• Has access to a smartphone and the internet.
• Able to understand Arabic.
• Provides electronic informed consent.
• Willing and able to participate for the 3-month study period.

Exclusion criteria

• Unable to use a smartphone or access the digital intervention.
• Cognitive or psychiatric impairment that could interfere with participation or completion of study assessments.
• Severe disability that prevents participation in the study procedures.
• Completely edentulous.
• Pregnant at the time of enrollment.
• Currently enrolled in another oral health intervention study.
• Planning to relocate during the 3-month study period.
• Medically unstable or considered unsuitable for participation based on clinical assessment.