Teaching Preschool Children Correct Toothbrushing Habits Through Playful Learning Interventions: A Randomized Controlled Trial

Abstract

This study aimed to investigate the effect of playful learning interventions (with toys, visual and auditory sources) on appropriate toothbrushing behaviors and the amount of accumulated plaque in preschool children.Design and methods: The study was carried out as a parallel-group, randomized and controlled study during the period October-December 2018, with 100 preschool children. The preschool students were randomly assigned to an intervention and a control group. The children in the intervention group were given instructions on how to brush their teeth while the children in the control group were not given any instruction outside of what they had learned in preschool. The playful learning interventions that were carried out consisted of three rounds of meetings designed to educate the children about adopting appropriate toothbrushing behaviors. Results: The study groups were well matched at baseline (p = .537) and the intervention group showed statistically significant improvements in toothbrushing (p = .001) and plaque control (p = .001) following the intervention in comparison to the controls. Additionally, while the amount of plaque decreased in the children in the intervention group (p = .001), plaque increased in the control group after the intervention (p = .001). Conclusions: This study showed that after the playful learning interventions carried out with the preschool children, appropriate toothbrushing behaviors were acquired and there was a decrease in the amount of plaque. Application to practice: Nurses who work with preschool children could use toys and songs as effective and entertaining nursing interventions for developing correct toothbrushing behaviors.

Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials

“…These results demonstrate that it should not be the preferred method for oral health education of children and adolescents and must be supported by additional engaging and interactive measures for the target population, which was supported by the studies carried out by Angelopoulou et al 23 . and Akkaya and Sezici 22 …”

“…The included trials were from India ( n = 4), Iran ( n = 2), Greece, Syria, Turkey, and Jordan (one from each). The age group of the studied population was in the range of 4–15 years, with two studies 22,30 having participants in the 4–6 years of age group and one study 24 in 6–8 years of age group. Three of the studies included the age groups of 9–12 years 25,27,31 .…”

“…One article was included from other sources. Ten articles were finally included in this SR. [22][23][24][25][26][27][28][29][30][31] The details of the search results are summarized in the PRISMA chart (Figure 1), the search results from different databases in Appendix S2, and the excluded studies along with the reasons for exclusion in Appendix S3.…”

“…The plaque index was used in six of the studies, 22,[24][25][26][27]31 simplified Debris Index (DI-S) in three studies, [28][29][30] Gingival Bleeding Index in two studies, 26,27 Gingival Index in one, 25 and plaque score of Oral Hygiene Index was used in one study. 24 Plaque Index was modified in the trial performed by Saied-Moallemi et al, 27 and the index teeth were modified for primary teeth in the study carried out by John et al 30 Improvement in knowledge levels was assessed in six studies (Tables 2-4).…”

“…Among the included trials, low ROB was observed in only the study carried out by Aljafari et al, 24 whereas six of them had high 26,27,[29][30][31] and three had moderate ROB (Figure 2). 22,25,28 The most common paucities were related to randomization, missing outcome data, and measurement of outcomes. The GRADE approach resulted in the downgrading of most of the outcomes to a very low level.…”