Toothbrushing Performance and Oral Cleanliness after Brushing in 12-Year-Old Children

Abstract

Objectives: Nationwide prevention programs in Germany aim to promote oral health. The group prevention program starts in kindergarten and ends when the children are about 12 y old. While in a recent study, toothbrushing behavior of 12-y-old children was analyzed, the present study’s objective was to examine the children’s ability to achieve oral cleanliness and to analyze how toothbrushing behavior and compliance with the toothbrushing recommendations taught in the group prevention programs predict oral cleanliness. Methods: Twelve-year-old randomly selected children ( N = 174) were asked to brush their teeth to the best of their abilities, and simultaneously a video was recorded for behavioral analyses. Plaque levels were measured before and immediately after toothbrushing. In addition, dental status and gingival bleeding were assessed. Results: After brushing to the best of their abilities, there was plaque on 50% (±24.72%) of all measured sites at the gingival margin (Marginal Plaque Index). Regression analyses revealed approximately 22% of the variance of marginal plaque on the outer surfaces to be explained by the time brushed by circular movements (β = −0.41; P < 0.001) and the number of sextants brushed for at least 7.5 s (β = −0.171; P < 0.05). Circular movements explained most additional variance (Δ R2 = 0.113; P < 0.001). With respect to inner surfaces, none of the behavioral aspects explained any variance of oral cleanliness. Conclusion: Despite regular group prevention measures, 12-y-old children show limited skills to clean their teeth adequately. Furthermore, none of the recommended behaviors relates to oral cleanliness after toothbrushing at inner surfaces. As a consequence, it is necessary to explore further which behavioral sequences effectively improve oral cleanliness. Knowledge Transfer Statement: This study illustrates that children’s compliance to toothbrushing recommendations is not necessarily related to toothbrushing effectiveness. Clinicians should therefore assess the effectivity of recommendations individually and provide individual guidance for improvement.

Good role models? Tooth brushing capabilities of parents: a video observation study

“…Hence, it is very likely that the efficacy of tooth brushing tends to be low or insufficient despite the regular performance of oral hygiene. This assumption is supported by many studies which report persistent plaque after brushing in different age groups [7][8][9][10][11][12][13][14].…”

Tooth brushing performance in adolescents as compared to the best-practice demonstrated in group prophylaxis programs: an observational study

“…Tooth contact time and the distribution of brushing movements and tooth contact on inner, outer and occlusal surfaces form the previous studies of the 12-year-olds [ 14 , 32 ] and 18-year-olds [ 13 ] are presented in the Appendix. Figure 2 shows the distribution of QIT-S-scores across all four age groups.…”

“…It also provides the benchmarks allowing for a detailed analysis of the degree to which the children comply outside the prophylaxis sessions to the best practice. These benchmarks have been applied for behavioural analyses in the present and former studies [ 14 , 32 ]. The song is available online in a video format so that children, their parents and their teachers could see it whenever they want to.…”

“…To further complement the analyses, data from previous studies with 12- and 18-year-olds [ 13 , 14 , 32 ] were reanalyzed to allow for direct comparison across different age groups based on some descriptive characteristics. Only those participants who had received the same brushing instruction (brushing to the best of one´s abilities) were included into this comparison.…”

The Oral Microbiota in Valvular Heart Disease: Current Knowledge and Future Directions

“…Each medical clinician should advise their patient to consult a dental doctor for professional advice. It is general knowledge that oral health maintenance is based on regular oral hygiene measures, i.e., flossing and brushing teeth, topical use of fluoride, routine dental care, and low cariogenic nutrition [ 81 , 82 ]. Effective brushing, dental floss, or inter-dental brush utilization, and oral rinses will improve oral dysbiosis.…”