Abstract
BackgroundGingivitis and other plaque-associated diseases have a high prevalence in western communities even though the majority of adults report daily oral hygiene. This indicates a lack of oral hygiene skills. Currently, there is no clear evidence as to which brushing technique would bring about the best oral hygiene skills. While the modified Bass technique is often recommended by dentists and in textbooks, the Fones technique is often recommended in patient brochures. Still, standardized comparisons of the effectiveness of teaching these techniques are lacking.Methodology/Principal FindingsIn a final sample of n = 56 students, this multidisciplinary, randomized, examiner-blinded, controlled study compared the effects of parallel and standardized interactive computer presentations teaching either the Fones or the modified Bass technique. A control group was taught the basics of tooth brushing alone. Oral hygiene skills (remaining plaque after thorough oral hygiene) and gingivitis were assessed at baseline and 6, 12, and 28 weeks after the intervention. We found a significant group×time interaction for gingivitis (F(4/102) = 3.267; p = 0.016; ε = 0.957; η2 = 0.114) and a significant main effect of group for oral hygiene skills (F(2/51) = 7.088; p = 0.002; η2 = 0.218). Fones was superior to Bass; Bass did not differ from the control group. Group differences were most prominent after 6 and 12 weeks.Conclusions/SignificanceThe present trial indicates an advantage of teaching the Fones as compared to the modified Bass technique with respect to oral hygiene skills and gingivitis. Future studies are needed to analyze whether the disadvantage of teaching the Bass technique observed here is restricted to the teaching method employed.Trial RegistrationGerman Clinical Trials Register DRKS00003488
Highlights
Though daily plaque removal is considered to be important for oral health [1,2], representative studies indicate this goal is not achieved by most patients
Overall intervention effects Overall analyses of covariance (ANCOVA) revealed a significant group6time interaction (F(4/102) = 3.267; p = 0.016; e = 0.957; g2 = 0.114) for gingivitis (Figure 2) and a significant main effect of group for oral hygiene skills measured with the marginal plaque index (MPI) (F(2/51) = 7.088; p = 0.002; g2 = 0.218)
This study aimed to compare the respective effects of three interactive computer presentations teaching the modified Bass or the Fones technique or the basics of oral hygiene alone
Summary
Though daily plaque removal is considered to be important for oral health [1,2], representative studies indicate this goal is not achieved by most patients. 70% of German patients report brushing their teeth twice a day [5] indicating that most patients do not sufficiently remove all plaque deposits. Current data suggest deficits in oral hygiene skills which might be overcome by teaching brushing techniques. Gingivitis and other plaque-associated diseases have a high prevalence in western communities even though the majority of adults report daily oral hygiene. This indicates a lack of oral hygiene skills. Still, standardized comparisons of the effectiveness of teaching these techniques are lacking
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