Toothbrushing is fundamental to oral hygiene. Children differ in manual dexterity and their grip on toothbrushes. We videotaped toothbrushing sessions and observed the grip type, duration of brushing, and brushing technique used among 100 children aged 8-12 years. We then investigated the association between grip type and plaque removal, using plaque scores obtained at various time points. We further examined the effect on plaque scores of standardizing both brushing technique and duration among the same participants. The most common grip was the distal oblique, followed by the oblique; the spoon and precision grips were rare, and no child used a power grip. Mean brushing duration for most children was 1.43 ± 0.85 min, and the most common brushing technique was horizontal scrubbing. We conclude that grip preference is inherent and that the distal oblique grip was better than the oblique grip in removing plaque. (J Oral Sci 54, [183][184][185][186][187][188][189][190] 2012)

Pain is a common experience during childhood. Despite the magnitude of effects that pain can have on a child, it is often inadequately assessed and treated. Numerous myths, insufficient knowledge among caregivers, and inadequate application of knowledge contribute to the lack of effective management. The pediatric pain experience involves the interaction of physiologic, psychologic, behavioral, developmental, and situational factors. Pain is an inherently subjective multifactorial experience and should be assessed and treated as such. Pediatric Dentists are responsible for eliminating or assuaging pain and suffering in children when possible. To accomplish this, we need to expand our knowledge, use appropriate assessment tools and techniques, anticipate painful experiences and intervene accordingly. As an assessment of pain which constitutes the foundation for all pain treatment, developing valid measures is both a clinical and research challenge. Clinicians and researchers should select measures with full knowledge of their psychometric strengths and weakness, as well as in keeping with their explicit conceptual model of pain. The purpose of this paper is to address potential sources of pain measurement, and responses to pain control and distractions based on the pediatric developmental stages.

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