A tailored tooth brushing program to control plaque accumulation and gingivitis among orphan children: A randomized trial

Abstract

Objectives: Poor oral hygiene among children is major cause of gingivitis, caries, and especially orphans constitute socially disadvantaged group. The objective of the study was to assess the efficacy of a tailored tooth brushing program to improve supragingival plaque control and gingival health among 13–17-year-old orphan children in Chennai city over a period of 21 days. Materials and Methods: A double-blind parallel, controlled clinical trial was conducted among 60 orphan children (28 males and 32 females) with mean age of 15.24 years. Dental plaque was assessed using the Turesky modification of Quigley-Hein index; gingival inflammation was assessed using gingival index at initial visit and after 14 and 21 days. Subjects were randomly allocated into one of two groups (study – audiovisual and individual demonstration of brushing technique with reinforcement at 14 days follow-up/control – only individual demonstration) and instructed to brush twice daily using modified bass technique with the toothbrush and paste provided throughout the trial. Results: The children who had audiovisual, individual demonstrations of brushing technique exhibited significantly superior total oral plaque control and significant reduction in the gingival inflammation at the end of 21 days trial (P < 0.05). The study group participants reported improved compliance and motivation to practice modified bass technique because of the reinforcement. Conclusion: The children who had both audiovisual and individual demonstration exhibited superior total plaque control and gingival health compared to control group and continued to demonstrate modified bass technique without any reinforcement at the end of 21 days trial.

A Scoping Review of the Oral Health Status, Oral Health Behaviours and Interventions to Improve the Oral Health of Children and Young People in Care and Care Leavers

“…Eight studies were identified that involved interventions to promote good oral health for CYP in care. Seven of these studies all involved an aspect of oral health education [21,28,85,88,[90][91][92], three also included an element of supervised brushing [28,85,90] and two of the studies had an additional component of dental treatment or preventative care [88,92].…”

“…Delivery modes of oral health education varied throughout the studies; audio-visual methods were the most commonly used [21,28,90,91]. In all of the studies, oral health education was delivered directly to the children, and in two of the studies, this was also delivered to caregivers [28,91].…”

“…In all of the studies, oral health education was delivered directly to the children, and in two of the studies, this was also delivered to caregivers [28,91]. The educational sessions varied in their delivery between group presentations [21] or group presentations accompanied by one-to-one teaching [90,91]. In the Khedekar et al study, it is unclear whether the education session was delivered to a group or on a one-to-one basis [28].…”

“…A further study compared an intervention group that received audiovisual and individual demonstration of the Bass brushing technique with reinforcement at 14 days follow-up to a control group that received the individual demonstration only. Post-intervention measures at 21 days showed children in the intervention group exhibited significantly higher total oral plaque control and significant reduction in the gingival inflammation (p < 0.05) [90]. Where toothbrushing was unsupervised, Shekhar et al looked at the efficacy of using electric toothbrushes in comparison to manual toothbrushes in this cohort.…”

“…Two of the studies utilised carers to reinforce oral health messaging and supervise toothbrushing [28,90]. Vijayasekaram et al had caregivers supervise the brushing of both the intervention and control group [90], both groups were given a one-to-one demonstration of the modified Bass technique, and the intervention group was given an additional audiovisual presentation of the technique as well as a reinforcement session after two weeks. Both groups had a reduction in plaque score with the reduction only sustained for the intervention group after two weeks.…”