The Effectiveness of Chatbot-Based Interventions in Promoting Oral Health Behavior Change Among Children and Caregivers: A Systematic Literature Review

Abstract

Oral diseases, particularly dental caries, remain a leading yet largely preventable public health burden among children, driven substantially by modifiable behavioral factors such as caregiver-led and self-performed toothbrushing practices. This study aims to systematically review the effectiveness of chatbot-based interventions in promoting oral health behavior changes among children and their caregivers. The method used is a Systematic Literature Review (SLR) approach guided by PRISMA 2020, with searches carried out in PubMed, ScienceDirect, and Scopus. A search across the three databases identified 291 records, of which 3 studies met the predefined eligibility criteria following title/abstract screening and full-text assessment. The included studies employed two distinct theoretical frameworks: the Protection Motivation Theory (PMT), applied to caregiver-mediated chatbot interventions for infants and toddlers, and the Behavior Change Wheel (BCW)/COM-B model, applied to a gamified chatbot delivered directly to school-aged children. Across all three studies, chatbot interventions were associated with significant improvements in toothbrushing frequency, PMT-based perceptions (with the exception of perceived vulnerability), and consistently high usability and satisfaction ratings. Overall, chatbot-based interventions are a promising and well-accepted tool for oral health behavior change, while highlighting the need for more rigorous, longer-term, and cross-culturally validated research to confirm their comparative effectiveness.