Patient Education and AI-Assisted Complaint Summaries in Endodontic Patients

The Effect of Different Patient Education Methods in Patients Presenting to an Endodontic Clinic With Toothache and the Feasibility of an AI-Assisted Complaint Summary

The goal of this randomized clinical trial is to compare the same-day effects of three standardized patient education methods in adults presenting to an endodontic clinic with toothache.

The main questions it aims to answer are:

• Does standardized verbal education improve patients' knowledge, reduce antibiotic-related misconceptions, and reduce anxiety?
• Does leaflet-based education produce comparable changes in knowledge, antibiotic-related misconceptions, and anxiety?
• Does video-based education produce comparable changes in knowledge, antibiotic-related misconceptions, and anxiety?
• Does teach-back performance differ according to the method used to deliver patient education?
• Can an AI-assisted three-sentence complaint summary be generated reliably and used as a feasible clinician-facing communication support tool?

Participants will be randomly assigned to one of three patient education groups.

In the verbal education group, participants will receive a standardized 90-second verbal explanation covering warning signs, appropriate home-care measures, avoidance of potentially harmful practices, and appropriate antibiotic use.

In the leaflet-based education group, participants will review a written leaflet containing the same core educational messages for 90 seconds.

In the video-based education group, participants will watch a short video presenting the same core educational messages for 90 seconds.

Knowledge level, antibiotic-related misconceptions, and anxiety will be assessed immediately before and immediately after the educational intervention. After education, participants will also be asked to restate the main messages in their own words using a teach-back procedure.

In addition, symptom information collected using standardized prompts will be entered into an artificial intelligence tool to generate a concise three-sentence complaint summary. The feasibility, completeness, and clinician-rated usefulness of these summaries will be evaluated as process outcomes. AI-generated summaries will not be used for diagnosis, triage, or treatment decisions.

Study Overview

• Status: Completed
• Conditions: Toothache; Dental Pain
• Intervention / Treatment: Behavioral: Standardized Verbal Education; Behavioral: Leaflet-Based Education; Behavioral: Video-Based Education

• Study Type: Interventional
• Enrollment (Actual): 120
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Sarıçam
    • Adana, Sarıçam, Turkey (Türkiye), 01250
      • Cukurova University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Reported pain of at least 1 point on a 0-10 numeric rating scale (NRS ≥ 1) at presentation,
• Were aged 18-65 years,
• Had sufficient cognitive capacity to complete the questionnaires, and
• Provided written informed consent.

Exclusion Criteria:

• Reported no pain at presentation (NRS = 0) or presented electively/asymptomatically,
• Required immediate emergency clinical evaluation due to signs suggestive of urgent intervention (e.g., marked diffuse swelling, dysphagia, dyspnea),
• Had substantial communication or cognitive difficulties preventing completion of the measures, or
• Were repeat participants (i.e., the same patient re-entering the study).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Standardized Verbal Education; Participants received a standardized 90-second verbal education session immediately after baseline assessment. The education covered warning signs requiring urgent dental care, appropriate home-care measures, avoidance of potentially harmful practices, and the appropriate use of antibiotics for dental pain. The content and sequence were delivered using a standardized script.	Behavioral: Standardized Verbal Education; Participants received a standardized 90-second verbal education session immediately after baseline assessment. The education included warning signs requiring urgent dental care, appropriate home-care measures, avoidance of potentially harmful practices, and guidance on the appropriate use of antibiotics for dental pain. A standardized script was used to ensure consistency of content and sequence.
Experimental: Leaflet-Based Education; Participants reviewed a written educational leaflet for 90 seconds immediately after baseline assessment. The leaflet contained the same core messages as the verbal education, including warning signs requiring urgent dental care, appropriate home-care measures, avoidance of potentially harmful practices, and the appropriate use of antibiotics for dental pain.	Behavioral: Leaflet-Based Education; Participants reviewed a written educational leaflet for 90 seconds immediately after baseline assessment. The leaflet included warning signs requiring urgent dental care, appropriate home-care measures, avoidance of potentially harmful practices, and guidance on the appropriate use of antibiotics for dental pain. The educational content was equivalent to that provided in the verbal and video groups.
Experimental: Video-Based Education; Participants watched a 90-second educational video immediately after baseline assessment. The video presented the same core messages as the verbal and leaflet-based education, including warning signs requiring urgent dental care, appropriate home-care measures, avoidance of potentially harmful practices, and the appropriate use of antibiotics for dental pain.	Behavioral: Video-Based Education; Participants watched a 90-second educational video immediately after baseline assessment. The video included warning signs requiring urgent dental care, appropriate home-care measures, avoidance of potentially harmful practices, and guidance on the appropriate use of antibiotics for dental pain. The educational content was equivalent to that provided in the verbal and leaflet-based education groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Patient Knowledge Score	Patient knowledge will be assessed using an 8-item questionnaire developed according to the standardized educational content. Each item will be scored as 1 for a correct response and 0 for an incorrect or unsure response, yielding a total score ranging from 0 to 8. Higher scores indicate greater knowledge. The change score will be calculated as the post-education score minus the baseline score (T1 - T0) and compared among the verbal, leaflet-based, and video-based education groups.	Immediately before the educational intervention and immediately after the educational intervention on the same day
Change in Antibiotic Misconception Score	Antibiotic-related misconceptions will be assessed using a 5-item Likert-type scale. Each item will be rated from 1 to 5, yielding a total score ranging from 5 to 25. Higher scores indicate stronger endorsement of antibiotic-related misconceptions. The change score will be calculated as the post-education score minus the baseline score (T1 - T0) and compared among the three education groups.	Immediately before the educational intervention and immediately after the educational intervention on the same day
Change in Anxiety Level	Anxiety related to the presenting dental pain will be assessed using a numeric rating scale ranging from 0 to 10, where 0 indicates no anxiety and 10 indicates the worst imaginable anxiety. The change score will be calculated as the post-education score minus the baseline score (T1 - T0) and compared among the verbal, leaflet-based, and video-based education groups.	Immediately before the educational intervention and immediately after the educational intervention on the same day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Teach-Back Critical Elements Score	Immediately after the educational intervention, participants will be asked to restate the main educational messages in their own words within approximately 20-30 seconds. Teach-back performance will be evaluated using five predefined critical elements. Each element will be scored as present or absent, yielding a total score ranging from 0 to 5. Higher scores indicate more complete recall of the educational content.	Immediately after the educational intervention on the same day
Teach-Back Global Adequacy Rating	The overall adequacy of the participant's teach-back response will be rated on a 3-point scale ranging from 0 to 2. A score of 0 indicates an incorrect, unsafe, or markedly incomplete response; a score of 1 indicates a partially correct response with missing critical elements; and a score of 2 indicates a correct and adequate response.	Immediately after the educational intervention on the same day
Generability of the AI-Assisted Complaint Summary	The ability to generate a concise three-sentence AI-assisted complaint summary from standardized, de-identified symptom information will be recorded as generated or not generated. The proportion of successfully generated summaries will be calculated for all participants.	During the same clinical visit, after collection of standardized symptom information
Completeness of the AI-Assisted Complaint Summary	The completeness of each AI-assisted complaint summary will be assessed according to the presence of five predefined symptom-related components. The completeness score will range from 0 to 5, with higher scores indicating more complete coverage of the required information.	Immediately after generation of the AI-assisted complaint summary during the same clinical visit
Clinician-Rated Usefulness of the AI-Assisted Complaint Summary	The usefulness of the AI-assisted complaint summary for structuring the clinical encounter will be rated by a single endodontist on a numeric rating scale ranging from 0 to 10, where 0 indicates not useful at all and 10 indicates extremely useful.	Immediately after review of the AI-assisted complaint summary during the same clinical visit

Collaborators and Investigators

• Sponsor: Cukurova University

Publications and helpful links

General Publications

• Nassar AA, Aboalshamat KT, Alsanei BS, Alghamdi AS, Fudah AA, Alhilou AM. The effect of educational animation compared to leaflets on patients' knowledge regarding root canal treatment: a randomized controlled trial. BMC Med Educ. 2024 Jul 29;24(1):808. doi: 10.1186/s12909-024-05812-5.

Study record dates

Study Major Dates

• Study Start (Actual): December 15, 2025
• Primary Completion (Actual): March 12, 2026
• Study Completion (Actual): April 24, 2026

Study Registration Dates

• First Submitted: July 7, 2026
• First Submitted That Met QC Criteria: July 7, 2026
• First Posted (Actual): July 13, 2026

Study Record Updates

• Last Update Posted (Actual): July 13, 2026
• Last Update Submitted That Met QC Criteria: July 7, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Stomatognathic Diseases; Tooth Diseases; Facial Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Toothache
• Other Study ID Numbers: 13.03.2026/104

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No