According to Gram Research analysis of a 2026 randomized trial with 154 parents, a 12-week text message program called SmilesUp improved children’s bedtime tooth-care routines, with 88.5% of families following them compared with 71.4% in the comparison group. Twice-daily brushing also rose, but that difference was not statistically significant.
Tooth decay is one of the most common childhood diseases, and it is largely preventable. A new study, reviewed by Gram Research analysis, tested whether a 12-week text message program could help parents of children aged 0 to 6 with early tooth decay. The program, called SmilesUp, sent three short messages each week with tips on brushing, bedtime routines, and sugary foods. Among 154 parents in Australia, the text messages were linked to better bedtime tooth-care routines and stronger knowledge about brushing. Brushing twice a day with fluoride toothpaste also rose, but that difference was not statistically significant. The researchers say text messaging may be a practical, low-cost way to support families, though larger and longer studies are needed.
Key Statistics
A 2026 randomized controlled trial of 154 parents in Australia found that a 12-week SMS text message program increased adherence to bedtime tooth-care routines from 71.4% to 88.5% compared with standard dental care alone.
In the same 2026 trial, 92.0% of parents receiving the text message program correctly answered toothbrushing knowledge questions, compared with 78.8% of parents who received only standard dental care.
A 2026 trial found that 96.1% of parents assigned to the SmilesUp text message program completed all 12 weeks of the intervention.
The Quick Take
- What they studied: The researchers wanted to know whether a 12-week program of automated text messages could help parents take better care of their young children’s teeth, compared with families who received only standard dental care.
- Who participated: There were 154 parents of children aged 0 to 6 who had early tooth decay. They were recruited from six public dental clinics in New South Wales, Australia, including cities, country towns, and rural areas. Half received the text message program, and half did not.
- Key finding: Families who got the texts were more likely to follow a bedtime tooth-care routine, with 88.5% doing so compared with 71.4% of families in the comparison group. Knowledge about brushing also improved, with 92.0% answering correctly compared with 78.8%. The increase in twice-daily brushing (73.8% vs. 66.7%) was not statistically significant, meaning it could have happened by chance.
- What it means for you: If you are a parent, regular reminders about brushing and bedtime habits may help you stay consistent. This study was small and short, so it does not prove that the program prevents tooth decay. Talk with your child’s dentist about the best plan for your family.
The Research Details
This was a randomized controlled trial, which is one of the most reliable ways to test whether something works. Participants were assigned by chance to one of two groups. One group received the SmilesUp program, which sent three text messages each week for 12 weeks. The other group continued with usual dental care only.
Both groups kept getting regular treatment from their dental clinics, so the comparison shows the added value of the texts. The program was designed with input from parents, which the researchers call co-design. This helped make the messages practical and relevant to everyday family life.
Parents reported their own habits, such as how often they brushed their child’s teeth and whether they followed a bedtime routine. Researchers also measured parents’ confidence in managing their child’s oral health, which they called self-efficacy. Because the outcome assessors did not know which group each family was in, the results are less likely to be biased.
Random assignment helps make the two groups similar at the start, so differences at the end are more likely to come from the text messages themselves. Keeping assessors unaware of group assignment also reduces the chance that their judgments were influenced by expectations.
Because parents reported their own behaviors, the results depend on honest memory and self-reporting. Still, this design is a strong first step for testing a low-cost tool that could reach many families.
The study used a rigorous design, and most participants who were assigned to the program completed it (96.1%). However, only 80.5% of all participants completed the final follow-up, so some results may be affected by who dropped out. The study was conducted at six sites in one country, so results may not apply everywhere. The trial was published in a peer-reviewed journal, which means independent experts reviewed it before publication.
What the Results Show
The main goal was to see whether more parents brushed their children’s teeth twice daily with fluoride toothpaste. The text message group had a higher rate, at 73.8% compared with 66.7% in the comparison group. However, this difference did not reach statistical significance. In plain terms, the study could not confidently rule out that the gap happened by chance.
The program did show clearer benefits for bedtime routines. Families who received the texts were much more likely to follow a routine that supports healthy teeth, with 88.5% doing so compared with 71.4% in the comparison group. This difference was statistically significant, which means it is unlikely to be due to chance alone.
Parents in the text message group also showed significantly better knowledge about toothbrushing, with 92.0% answering correctly compared with 78.8% in the comparison group. Knowledge is an important step toward changing habits, although it does not always lead directly to behavior change.
Researchers also looked at how often children ate or drank sugary foods and drinks. Sugary food intake was lower in the text message group (16.4% vs. 6.3%, with the comparison group actually lower), and sugary drink intake was similar in both groups (41.0% vs. 42.9%). Neither difference was statistically significant, so the study did not show that the program reduced sugar consumption.
The researchers noted that most families who started the program finished it, which suggests the messages were acceptable and easy to follow. This is encouraging for future programs that rely on automated support.
Oral health experts have long recognized that parents play a central role in preventing early childhood tooth decay. The World Health Organization’s global oral health plan for 2023 to 2030 encourages the use of mobile health tools, such as text messages and apps, to support lasting habit change. This study adds to that effort by showing that a text-based program designed with parents can improve routines and knowledge in a real clinic setting.
The study was relatively small, with 154 participants, and only about four in five completed the final follow-up. The results were based on what parents reported about their own behavior, which may be less accurate than direct observation. The program lasted 12 weeks, so the study cannot show whether the benefits last over months or years. The trial also did not measure actual tooth decay or dental visits, so it cannot confirm that the program prevents cavities. Finally, the results come from one region of Australia and may not apply to other populations.
The Bottom Line
Based on this trial, text message reminders may be a helpful addition to dental care for young children, especially for building consistent bedtime routines and parent knowledge. Confidence in the bedtime and knowledge benefits is moderate because those results were statistically significant but come from a single small study. Confidence that the program improves brushing or prevents tooth decay is low, because the brushing result was not significant and clinical outcomes were not measured.
Parents of children aged 0 to 6 who have been diagnosed with early tooth decay may find this approach useful. Dental teams, public health programs, and clinics looking for low-cost ways to support families may also be interested. Parents of children without tooth problems may still benefit from the general habits described, but this study did not test that group. Families who need more intensive care should rely on their dentist’s guidance rather than text messages alone.
In this study, changes in bedtime routines and knowledge appeared within the 12-week program. Habits often take several months to become automatic, so parents should expect gradual progress rather than instant results. Any effect on cavities would take longer to show and was not measured in this trial. Regular dental checkups remain the best way to track real tooth health over time.
Frequently Asked Questions
Can text messages help parents brush their toddler’s teeth better?
A 2026 randomized trial of 154 parents found that text messages did not significantly increase twice-daily brushing, which rose from 66.7% to 73.8%. The gain was not statistically significant, though bedtime routines and toothbrushing knowledge improved more clearly.
What is the SmilesUp program for early childhood tooth decay?
SmilesUp is a fully automated 12-week text message program that sends three messages each week to parents of children aged 0 to 6 with early tooth decay. It offers tips on brushing, bedtime routines, and sugary foods, and was designed with parent input.
Does a bedtime tooth-brushing routine help prevent cavities in young children?
A 2026 trial found that 88.5% of parents receiving text message support followed a bedtime tooth-care routine, compared with 71.4% in the comparison group. The study did not measure cavities directly, so it cannot confirm that the routine prevents tooth decay on its own.
How common is early childhood tooth decay, and can it be prevented?
Early childhood tooth decay is a common disease that affects young children’s health and quality of life. Experts consider it largely preventable through habits such as fluoride toothpaste use, limiting sugary foods, and regular dental visits, as outlined in the World Health Organization’s 2023 to 2030 oral health plan.
Want to Apply This Research?
- Log each day whether your child brushed twice with fluoride toothpaste and whether the bedtime routine was completed. Track these as simple yes or no entries and calculate a weekly percentage. Also note how many sugary snacks or drinks your child had each day.
- Set two daily reminders, one for morning brushing and one for the bedtime routine. Pair brushing with an existing habit, such as after breakfast or right after bath time. Choose a fluoride toothpaste your child likes, and let them pick their own brush to make the routine more fun.
- Review your weekly percentages once a month to spot patterns, such as missed bedtime routines on busy nights. Share your log at each dental visit so your dentist can see your progress. If you notice that routines are slipping, adjust reminders or simplify the routine rather than giving up on it.
This article summarizes a single randomized trial of 154 parents in Australia and is for general information only. It is not medical or dental advice. Text message programs are not a replacement for care from a dentist or pediatrician. Talk with your child’s dental professional before changing your child’s oral health routine, especially if your child has existing tooth decay.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.