Effectiveness of an App-Based Mobile Intervention for Precision Oral Self-Care in Patients with Periodontitis from Initial Therapy to Re-Evaluation

Round 1

Reviewer 1 Report

The manuscript aims to evaluate the intervention effectiveness of the oral self-care mobile application (OSCA). The topic is current and interesting. The manuscript is mainly fluently written but contains several repetitions, e.g. ‘OSCA was developed as an evidence-based and personalized app by adopting the framework of the Behavior Change Wheel…’ is said several times throughout the text. I recommend revising and compressing the text thoroughly to avoid unnecessary repetition and to make it more comfortable to read.

My suggestions and comments in detail:

Title: because the intervention was quite short, I suggest changing the title as ‘Effectiveness of a short app-…’

Introduction:

The authors state that almost 100% of adults and 60-90% of schoolchildren suffer from caries, please give a proper reference for this.

The last paragraph is too long, please state the aims of the study more precisely.

Materials and methods

How was the size of the study group defined? Any power calculation, if not, why?

How was the randomization performed?

The flow chart is informative, but also the timing of the reevaluation could be shown here. This the reevaluation visit is somewhat confusing. It is said (page 4, line 83) that participants were asked to perform daily oral self-care using OSCA for approximately 4-8 weeks. Why not exact time? The reason for this indefinite period for the intervention should be explained (and probable impact on the results).

What is known about the general health of the participants?

Results

The first paragraph repeats the information given already in 2.1. Inclusion criteria and procedure.

 

Discussion

Please revise and compress, now it contains repetition. I suggest to delete p-values from discussion. More discussion about the limitations of the study (possible confounders, variation in reevaluation time etc.)

Conclusions

Conclusions should be more precise; the first sentence is not a conclusion of this study.

Author Response

Dear Reviewer,

We would like to thank your valuable comments on the manuscript. To address the concerns raised, the title has been changed and the manuscript was modified according to your comments.

On behalf of all the co-authors

Yours sincerely

Wen-Jen Chang

Author Response File: Author Response.pdf

Reviewer 2 Report

This is and interesting study which in general has been reported well.

In the opinion of this reviewer three points need to be addressed before the manuscript can be accepted for publication.  They are as follows:

1.The use of the term "periodontal disease" is very misleading.  The patients in this study all had periodontitis.  The title should be changed accordingly by deleting the words "periodontal disease" and replacing them with "periodontitis."  Elsewhere in the manuscript the same change should be made.  In the future will the authors please remember that since the advent of the AAP/EFP classification, the term "periodontal disease" is rudundant and depending on the context should be replaced either by periodontal diseases or ginigivitis or periodontitis.

2. It is unclear whether the 150 patients recruited between September 2018 and October 2019 were all patients, who attended their clinic with periodonitis, requiring non-surgical treatment only or only those who volunteered to take part in the study.  Please clarify this point and include a statement such as: " out of the XXX patients who attended the YYY clinic between  September 2018 and October 2019, with a diagnosis of generalised  aggressive or chronic periodontitis requiring non-surgical treatment,  150 volunteered to take part in the study." 

3. The fact that over 40% (62 out of 150) patients did not complete the study has not been discussed.  It must be and reasons why they did not wish to use the App should be suggested.

 

 

Author Response

Dear Reviewer,

We would like to thank you for your valuable comments on the manuscript. To address the concerns raised, the title has been changed and the manuscript was modified according to the comments below.

On behalf of all the co-authors

Yours sincerely

Wen-Jen Chang

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

The authors have revised the manuscript according to my comments and suggestions. The manuscript can be accepted for publication