4. Discussion
adolescence, chronic disease, caries, primary dentition
CARIES, CHRONIC DISEASE
The results of this study suggest that the online caries management platform has more advantages in caries risk items, oral health knowledge and oral health behaviors than the traditional lecturing.The online caries management platform provides a reliable implementation path for the occurrence and persistence of health-related behaviors. The significant increase in the use rate of fluoridated toothpaste and the extension of brushing time in the experimental group were mainly attributed to the functional modules of toothpaste ingredient list uploading, brushing time recording and personalized health education on the online caries management platform. A six-year oral health promotion programme carried out in school for children in Wuhan city, PR China suggested that use rate of fluoridated toothpaste was improved to 27.47% (Oral health knowledge and attitude improved after 1 year in both groups, but not by much from the baseline. It is relatively easy to improve health knowledge and attitude, but it is difficult to change health behavior (Health-related information and motivation can activate behavioral skills and motivate the target population to initiate and sustain healthy behaviors. Early adolescence is a life stage in which many health behaviors are perpetuated. Health interventions during early adolescence are likely to produce a long-term impact on one's health outcomes (In this study, oral health education and behavioral intervention based on lifestyle were implemented. Previous studies on the ways of health education include traditional lecturing, experiential learning (The index for caries in primary dentition (decayed-missing-filled surfaces index, dmfs) was not taken into consideration since many of the primary teeth were lost during the mixed dentition stage and it would bias the results (Compared with traditional lecturing, the online caries management platform can reduce the limitation of time and space on the communication between doctors and patients. According to the caries risk items of different individuals, the online caries management platform focuses on the implementation of oral health education in insufficient aspects. The oral health education strategy of the target population varies from person to person, and personalized health guidance can be achieved.The effect of chronic disease management is mainly reflected in the change of various measuring indicators, which can be divided into clinical indicators and non-clinical indicators. Self-monitored physiological data and clinical examination results constitute clinical indicators. The behavior data of patients and the quality data of chronic disease management constitute non-clinical indicators. It is more and more convenient to use the Internet to obtain various measurement data of patients, and the accuracy and continuity are also gradually improved (The sample size and follow-up time of the study are limited, and a larger sample size and longer follow-up time are needed to evaluate the effect of this online platform on caries management. Since health literacy can be forgotten, the interval between implementing health education and evaluating participants' health literacy should be shortened in future studies. The participants in this study were all from the same city with poor population mobility. Random cluster sampling was conducted for them, and statistical analysis showed no difference in the education and socioeconomic status of their parents. The fluoride concentration of drinking water in the study area was not investigated and did not reach a suitable state. The study participants may intentionally provide more healthy attitude and behaviors compared with fact when filling out the questionnaire, which may lead to a bias. The physical and mental state of the study participants when filling out the questionnaire may affect the authenticity and accuracy of the items involved in the questionnaire, leading to a recall bias.