Caraban, A., Ferreira, M. J., Gouveia, R., Karapanos, E. (2015) Social Toothbrush: Fostering Family Nudging around Tooth Brushing Habits. In adjunct proceedings of Ubicomp’15 In this paper we present Social Toothbrush, a hardware plugin for electric toothbrushes that aims to induce proper tooth brushing behaviors on young children and adults. Social Toothbrush does so by taking advantage of family communication and coordination practices to encourage healthy practices. We first describe the theoretical grounding of our design process, Social Translucence, followed by the design and development of Social Toothbrush.

1. Ana Caraban
Social Toothbrush: Fostering Family Nudging
around Tooth Brushing Habits.
Caraban, A., Ferreira, M. J., Gouveia, R., Karapanos, E. (2015) Social Toothbrush: Fostering Family Nudging
around Tooth Brushing Habits. In adjunct proceedings of Ubicomp’15

2. Problem
statement
1. Individuals often fail to adopt a healthy tooth brushing habit
2. 50% of the European union’s population suffers from an oral
disease
3. Tooth decay, bad breath, gum disease stand out among the
common oral diseases. However, can have detrimental effects to
chronic conditions
4. Oral diseases are the fourth most expensive disease to treat
5. Resources needed to prevent are much lower than treatment

3. Frequency
PROBLEM STATEMENT: TOOTH BRUSHING BEHAVIORS
PROPER ORAL HEALTH BEHAVIORS
Duration Performance

4. Literature
review
Behavior change theories,
Research efforts

5. Motivation
to achieve the
goal
Ability
to perform it
Trigger
to initiate the
behavior
3 properties that must converge at the same moment for a behavior to occur
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS
FOGG’S BEHAVIOR MODEL

6. Motivation
to achieve the
goal
Ability
to perform it
Trigger
to initiate the
behavior
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS
FOGG’S BEHAVIOR MODEL
3 properties that must converge at the same moment for a behavior to occur

7. Motivation
to achieve the
goal
Ability
to perform it
Trigger
to initiate the
behavior
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS
FOGG’S BEHAVIOR MODEL
3 properties that must converge at the same moment for a behavior to occur

8. Spinbrush
Tooth tunes
Beam brush
Squeaky clean teeth
Oral-b smartseries 5000
Molarcropolis
Plaque attack
Aquafresh brush time
TECNOLOGICAL SOLUTIONS
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS

9. Colorful toothbrushes
Tasteful toothpastes
COMERCIAL SOLUTIONS
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS

10. When an individual is committed to perform a behavior and sets complex and
specific goals, he is more likely to achieve the task
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS
GOAL SETTING THEORY

11. Vision-based motion tracker in the bathroom that provides real-time visualizations about the children’s performance
Interactive game aims to induce the children to complete the task of cleaning a virtual group of teeth
LITERATURE REVIEW: BEHAVIOR CHANGE THEORIES AND CONTRIBUTIONS
PLAYFUL TOOTHBRUSH

12. LITERATURE REVIEW: PERSUASIVE TECHNOLOGIES
THESE TECHNOLOGIES ONLY FOCUS ON ONE INDIVIDUAL
It’s the role of the technology to persuade the individual

13. WHAT IF WE PUSH RESPONSABILITIES TO FAMILY MEMBERS?
We now think of technologies as Social Translucent rather than
persuasive. Their role is to make behaviors visible and support family
members in establishing norms around their behaviors
LITERATURE REVIEW: PERSUASIVE TECHNOLOGIES

14. 1. Visibility
Presenting socially significant
information to others
LITERATURE REVIEW: THEORETICAL GROUNDING
THE SOCIAL TRANSLUCENCE THEORY

15. 1. Visibility 2. Mutual Awareness
Presenting socially significant
information to others
One’s realizations that her actions
are being shared and
that others are aware of her
behaviors (“I know that you
know”)
THE SOCIAL TRANSLUCENCE THEORY
LITERATURE REVIEW: THEORETICAL GROUNDING

16. 1. Visibility 2. Mutual Awareness 3. Accountability
Presenting socially significant
information to others
One’s realizations that her actions
are being shared and
that others are aware of her
behaviors (“I know that you
know”)
Individuals now feel accountable
about their behavior and will act in a
manner to gain or maintain others
approval
THE SOCIAL TRANSLUCENCE THEORY
LITERATURE REVIEW: THEORETICAL GROUNDING

17. Survey
Understanding
user’s needs and
practices
47 individuals
Interviews
11 families, 49 individuals

18. Self reported behaviors
2 or more times a day97%
Reported brushing for 2
min (~2.37 min)59%
UNDERSTANDING USER’S NEEDS AND PRACTICES
SURVEY

19. Self reported behaviors
2 or more times a day97%
Increase the frequency
by 1 time/day
43%
2 or more times/day18%
61%Reported brushing for 2
min (~2.37 min)59%
SURVEY
Self reported goals
UNDERSTANDING USER’S NEEDS AND PRACTICES

20. 39%
21%
17%
12%
Lack of motivation
Unattractiveness of the task
Time constrains
Frenetic lifestyles,
Rotating schedules
Missing
Routines
Lack of
Information
Barriers against healthy
tooth brushing practices
SURVEY
UNDERSTANDING USER’S NEEDS AND PRACTICES

21. Intra-family awareness
59% Aware of other family members’
tooth brushing practices
16% Common routines
9% As attempt to remind each other
SURVEY
UNDERSTANDING USER’S NEEDS AND PRACTICES

22. Intra-family influence
90% Often attempt to influence
others’ tooth brushing habits
SURVEY
71% Of children are influenced by their parents
UNDERSTANDING USER’S NEEDS AND PRACTICES

23. “[P6] I turn the radio on every morning and only turn it off when I am leaving
home. I think it motivates me to perform my daily practices and I end up
leaving home in a good mood”
Parents reported several strategies to help children engage
with the task:
INTERVIEWS
UNDERSTANDING USER’S NEEDS AND PRACTICES

24. Three main features for an effective social system:
A playful and
appealing system
(visually and
functionally)
1
Increases
transparency of
tooth brushing
behaviors
2
Enhances positive
communication
among family
members’
3
IMPLICATIONS FOR DESIGN
UNDERSTANDING USER’S NEEDS AND PRACTICES

25. Smartholder is a usual toothbrush holder that senses tooth
brushing behaviors and provide feedback accordingly
A semitransparent ring that provides information about
the user tooth brushing frequency surrounds each hole
On the front side of the holder four led lights per user
provide instance awareness of tooth brushing duration
SMARTHOLDER: SENSING FREQUENCY AND DURATION

26. Music and micro-learning audio-
clips are played throughout tooth
brushing, according to users’
preferences and time of the day
Arduino mega board, leds, infrared pair,
low power audio amplifier, speaker,
resistors, MP3 music player and 3D
printed case
The holder senses when each toothbrush
is (or not) present in the holder through
infrared technology placed in the
bottom
Material needed Arrangement Light feedback Audio feedback
Feedback is displayed
in the top and front
sides
SMARTHOLDER: DESIGN AND DEVELOPMENT

27. SOCIAL TOOTHBRUSH: SENSING FREQUENCY, DURATION AND PERFORMANCE

28. Microcontroller
Motion sensor
Bluetooth module
SD card module
RTC clock
RGB led
Battery + electronics for the inductive charging
3D printed case
SOCIAL TOOTHBRUSH (EXTENSION): SENSING FREQUENCY, DURATION AND PERFORMANCE

29. Data acquisition
We analyze the angle in
which the toothbrush
bristles are against the
fixed coordinate frame
Patterns classification
We displayed the waveforms of
sensor readings and based on
given thresholds, we obtained and
identified position patterns
Validation of the approach
We asked 8 individuals to perform
two tooth brushing activities
during a week, using the sensing
platform, in a laboratory
environment
Areas recognized
Preliminary results revealed
high accuracy for the
detection of six areas yet,
certain ambiguity was present
in the inner regions
SOCIAL TOOTHBRUSH (EXTENSION): SENSING FREQUENCY, DURATION AND PERFORMANCE

30. SOCIAL TOOTHBRUSH (EXTENSION): FEEDBACK
Good behavior Poor behavior Lack of behavior

31. SOCIAL TOOTHBRUSH (MOBILE APP): FEEDBACK
Messages that
provides practical advices
Family member’s behaviors
Weekly or real-time mode
Visual representation of
mouth areas and respective
brushing stage
Current tooth brushing duration
Motivational
messages
Brushing frequency

32. FINAL NOTES
Literature reviews showed a lack of systems that support users attaining a proper frequency, duration and performance (at
once)
The domain currently lacks an understanding of the effectiveness of different approaches in motivating tooth brushing behaviors through
the role of family
With this work we were able to:
- Understand that frequency, duration and performance of tooth brushing behaviors could be measured using
appropriate technology
- Create two systems that could be embedded in a normal household
- Provide means to families to coordinate tooth brushing practices by raising family member’s awareness of each
other’s behaviors
CONCLUSION

33. SmartHolder: sensing and raising families' awareness of tooth brushing habits.
Caraban, A., Ferreira, M. J., Belim, V., Lyra, O., & Karapanos, E. (2014, June).
In Proceedings of the 2014 conference on Interaction design and children (pp. 341-344). ACM.
Social Toothbrush: Fostering Family Nudging around Tooth Brushing Habits.
Caraban, A., Ferreira, M. J., Gouveia, R., Karapanos, E. (2015)
In adjunct proceedings of Ubicomp’15
CONTRIBUTIONS
FINAL NOTES

34. Conduct a longitudinal field study of the Social Toothbrush:
• Understand the effectiveness of Social Toothbrush as a Socially Translucent technology
• Understand how Social Toothbrush can affect family communication and coordination practices
around tooth brushing
• Understand if Social Toothbrush can sustain users’ engagement over time
FUTURE WORK
FINAL NOTES

35. THANK YOU