Aim: To assess and compare the effectiveness of Manual toothbrushing reinforced with audiovisual instructions with powered toothbrushing, among the institutionalized mentally challenged individuals under supervision of trained caretakers. Materials and Methods: A randomized cross over clinical trial of 6 months duration which included 16 subjects consisting of two phases of three months, for each of the 2 groups. In group A subjects were given manual toothbrushes with audio-visual aid followed by the powered toothbrushes & vice versa for group B. All subjects were instructed by trained care takers.