Innovative oral hygiene strategies for children with autism spectrum disorder: a gamified app-based intervention

Purpose: This study aimed to evaluate the effectiveness of the “Marzhan Tis” mobile application in improving oral hygiene practices among children with autism spectrum disorder (ASD) and to examine its usability and correlation with learning success. Methods: A prospective cohort study was conducted with 90 children with ASD aged 3-18 years from rehabilitation centers in Almaty, Kazakhstan. Participants were assigned to either a control group (CG) or intervention group (IG), the latter using the app for one month. Oral hygiene was assessed using OHI-S, API, and PMA indices, and adherence was measured with the OHAS-10 scale. A structured 15-item parental questionnaire evaluated behavioral changes and app usability. Data were collected at baseline and one month post-intervention, and analyzed using chi-square tests and Pearson correlation. Results: Significant improvements in oral hygiene were observed in the IG across all age groups (OHI-S reduction: 28-52%, p<0.05). The API and PMA indices improved by over 50% (p < 0.001). Oral hygiene adherence increased by 18.8% (p = 0.001). Following app use, 85% of children demonstrated improved hygiene independence (χ² = 28.7, p = 0.001). Correlation analysis revealed a moderate to strong positive association between app usability and learning success (r = 0.65, p = 0.01). Conclusion: The “Marzhan Tis” application significantly improved oral hygiene skills and self-care independence in children with ASD. The findings support the role of interactive mobile technologies in promoting oral health and highlight their potential for integration into dental education and public health strategies.