Oral Hygiene Instruction Research Articles

Effect of Traditional and Virtual Oral Hygiene Instruction to School Health Instructors on Plaque Index of Elementary Schoolchildren

AIM: This study compared the effect of traditional and virtual oral hygiene instruction to school health instructors on plaque index (PI) of elementary schoolchildren. METHODS AND MATERIALS: In this descriptive, analytical study, 66 elementary schools in Kermanshah city were selected by cluster sampling. The school health instructors first participated in a pretest and filled out a questionnaire. The O’Leary’s index of 339 elementary schoolchildren was measured at baseline. Next, the school health instructors received oral hygiene instructions in two groups (n = 33) of virtual instruction through an online course and traditional classroom setting. After 3 weeks, a post-test was held and school health instructors filled out the same questionnaire for the 2nd time. After 3 months, the PI of students was measured again. Data were analyzed using the Chi-square test, t-test, Mann–Whitney U-test, and ANOVA. RESULTS: Both instruction methods significantly enhanced the oral hygiene knowledge of instructors (p < 0.001) but virtual instruction was significantly more effective (p = 0.02). No significant association was noted between age, work experience of instructors, or their level of education with their knowledge level in the virtual group (p > 0.05). An inverse correlation was noted between age and work experience of instructors with their knowledge level in the traditional instruction group (p < 0.05). Both instruction methods caused significant improvement of PI of students (p < 0.001) but virtual instruction was more effective (p < 0.001). CONCLUSION: Correct oral hygiene instruction to school health instructors (preferably by virtual instruction) can reduce PI elementary schoolchildren.

Daily Tasks and Willingness to Work of Dental Hygienists in Nursing Facilities Using Japanese Dental Hygienists' Survey 2019.

Oral health care by dental hygienists contributes to the maintenance of nutritional and general health for older people in nursing facilities. This study aimed to investigate daily tasks and willingness to work among dental hygienists working in nursing facilities in Japan. In 2019, using a self-administered questionnaire, a postal cross-sectional survey was conducted among members of the Japanese Dental Hygienists’ Association. Questionnaires were distributed to all 16,722 Association members (responses, n = 8932; return rate, 53.4%). We analysed data from 368 dental hygienists currently working in nursing facilities. Item response theory and correspondence analyses were performed. In total, >90% of dental hygienists undertook oral examinations and provided oral hygiene instructions to residents and facility staff. In contrast, the implementation rate of tasks related to interprofessional collaboration was relatively low (approximately 50%), and 72.6% of dental hygienists indicated that they wanted to continue working in nursing facilities. Their willingness to work was closely associated with work involving interprofessional collaboration. Our study findings showed that dental hygienists’ work content in nursing facilities was diverse, but that there was variation in implemented tasks. Willingness to continue working in nursing facilities was associated with interprofessional collaboration among dental hygienists.

Patient acceptance of «Guided Biofilm Therapy»

«Guided Biofilm Therapy» (GBT) represents a systematic, risk and demand-oriented prophylaxis and treatment concept. A significant difference to conventional methods is - above all - the reduced, tissue-friendly and targeted use of ultrasound and hand instruments. The biofilm is consistently shown with suitable color solutions, the oral hygiene instruction and professional tooth cleaning is optimized. The use of suitable powders guarantees a tissue-conserving and targeted removal of biofilm. While individual treatments, techniques and materials have already been well investigated and described, little data is available on patient acceptance. The aim of the present study was to gain an impression of the acceptance of this method in comparison to the conservative-classical recall care mainly based on hand and ultrasound devices in a survey of 100 consecutive patients from the clinic's internal recall system. The overall results were very positive. The powder jet device showed the best acceptance. The aspect fear before/during the recall session was also interesting: At a low level (10%), an additional reduction to 4% occurred, since hand instruments were probably used much less and only very specifically. mConclusion: The use of plaque elevators makes the work in the recall session more efficient, more effective and guarantees ma higher quality control, which is also highly appreciated by patients.

Are oral hygiene instructions with aid of plaque-disclosing methods effective in improving self-performed dental plaque control? A systematic review of randomized controlled trials.

To systematically evaluate the literature on whether plaque-disclosing (PD) methods, applied by dental professionals (FQ1) or at-home (FQ2), combined with verbal oral hygiene instructions and brushing demonstration (standard OHI) lead to improvements in self-performed dental plaque control in comparison to standard OHI alone. Seven databases were searched by two independent reviewers according to pre-specified eligibility criteria up to September 2020. No restrictions regarding language, date and type of report were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal. Multiple comparisons referring to a single study were included if the articles evaluated different PD agents. Narrative synthesis using evidence tables were performed. Seven eligible studies were retrieved, including data of 430 individuals (159 wearers of orthodontic appliances). The studies exhibited considerable heterogeneity regarding outcome assessments and follow-up. Eleven (eight corresponding to FQ1 and three to FQ2) out of 13 relevant comparisons found no significant difference between techniques for dental plaque outcomes and three (two corresponding to FQ1 and one to FQ2) out of five comparisons indicated a positive effect of standard OHI with aid of PD methods on gingival inflammation scores. With respect specifically to orthodontic patients, three out of four comparisons indicated significant improvements on gingival inflammation scores for individuals instructed with PD methods. Clinicians should consider PD agents as adjunct to standard OHI in orthodontic patients. For those without appliances, PD methods can be used as an alternative.

Dentists' preferences in implant maintenance and hygiene instruction.

This study investigated the preferences of dentists in Australia in providing professional implant maintenance and implant-specific oral hygiene instructions (OHI). General dentists were surveyed online about their preferences in peri-implant diagnostics, maintenance provision, armamentarium used, and implant OHI techniques and frequency. Most of the 303 respondents (96%) provided maintenance services; 87.6% reviewed implants regularly while 10.7% only performed diagnostics after detecting clinical signs/symptoms. Supragingival prosthesis cleaning was performed by 77.9% of respondents, 35.0% performed subgingival debridement, 41.9% treated peri-implant mucositis and 18.2% treated peri-implantitis. About 15% did not treat nor refer peri-implant disease, including significantly more non-implant providers and dentists without implant training. Maintenance armamentarium commonly included floss (76.3%), prophylaxis (73.9%), plastic curettes (43.3%) and stainless-steel ultrasonics (38.0%). Brushing (86.5%), flossing (73.9%) and interdental brush use (68.3%) were most commonly recommended. Implant OHI was repeated routinely by 57.4% of dentists who provided it. Dentists with greater implant training and experience were more likely to perform reviews and complex maintenance procedures. Peri-implant diagnostics performed, treatments provided and armamentarium varied among dentists. Implant providers and those with higher levels of training had more preventative approaches to implant OHI. Possible shortcomings in disease management and OHI reinforcement were identified.

The Influence of Oral Hygiene Education on The Oral Health Status of Patients Suffering from HIV/AIDS

Introduction: Poor oral hygiene and dental care can affect oral intake which results in decreased endurance and increases the risk of opportunistic or systemic infections. Method: The research was carried out the RSUD dr. M. Haulussy Ambon, Maluku, Indonesia, using a quasi-experimental method, involving 30 nurses and 20 patients. The level of knowledge and skills is evaluated before and after oral hygiene education for nurses. Patients were measured with a Beck Oral Assessment Scale (BOAS) score, and C. albicans yeast culture before and after the intervention was given in the form of oral hygiene using a soft toothbrush and dental floss for one week. Result: The influence of oral hygiene education on nurses knowledge with median value of pre-education 36.00 and post-education 91.00 and nurse skills have median value of pre-education 67.00 and post-education 100.00 with a significant value of p = 0.001 <0.05. There is an increase in knowledge and skills after educational activities. Before oral hygiene treatment was applied with a review of the BOAS score it had a median value of 11.00 after the intervention became 6.00 a significant value of p= 0.001<0.05, which showed a decrease in scores after oral hygiene treatment. Examination of C. albicans fungus with a median value of 79.00 pre-intervention and 31.00 at post-intervention, a significant value of p= 0.001, showed a decrease in the number of post-intervention fungi. Conclusion: Nurses should conducted Oral hygiene regularly to improve oral health status of AIDs patiens.

Association among periodontitis severity, anti-agalactosyl immunoglobulin G titer, and the disease activity of rheumatoid arthritis.

The aim of the present study was to evaluate the association between the periodontal and serological parameters and the disease activity of rheumatoid arthritis (RA) and between the anti-agalactosyl immunoglobulin G (IgG) titer and periodontitis severity. The objective was also to assess the effect of supragingival scaling on the serological parameters in patients with RA. The periodontal and serological parameters in relation to the autoimmune inflammatory response have been linked to RA disease activity. However, the association of the anti-agalactosyl IgG titer with RA disease activity and periodontitis severity has not been elucidated. The periodontal, rheumatologic, and serological data were collected from 127 patients with RA in a retrospective cohort study. Of the 127 patients, 21 had been randomly assigned to receive oral hygiene instruction and supragingival scaling. The anti-agalactosyl IgG titer was determined by an electrochemiluminescence immunoassay. The patients with a moderate to high RA disease activity showed significantly higher levels of probing depth (PD), clinical attachment level, anti-cyclic citrullinated peptide IgG, and anti-agalactosyl IgG titer and greater mean percentages of severe periodontitis than those with a low RA disease activity (p<.05 for all). Both univariate and multivariate analyses revealed a significantly positive correlation between the PD and RA disease activity (p=.009 and p=.001), between the anti-agalactosyl IgG titer and RA disease activity (p=.002 and p<.001), and between the anti-agalactosyl IgG titer and PD (p<.001 for both). Supragingival scaling significantly decreased the anti-agalactosyl IgG titer (p=0.03). The PD and anti-agalactosyl IgG titer are positively interrelated, both of which are correlated positively with RA disease activity and influenced by supragingival scaling in patients with RA.

Longitudinal caries prevalence in a comprehensive, multicomponent, school-based prevention program

BackgroundGlobally, children’s caries prevalence exceeds 30% and has not markedly changed in 30 years. School-based caries prevention programs can be an effective method to reduce caries prevalence, obviate traditional barriers to care, and use aerosol-free interventions. The objective of this study was to explore the clinical effectiveness of a comprehensive school-based, aerosol-free, caries prevention program. MethodsThe authors conducted a 6-year prospective open cohort study in 33 US public elementary schools, providing care to 6,927 children in communities with and without water fluoridation. After dental examinations, dental hygienists provided twice-yearly prophylaxis, glass ionomer sealants, glass ionomer interim therapeutic restorations, fluoride varnish, toothbrushes, fluoride toothpaste, oral hygiene instruction, and referral to community dentists as needed. The authors used generalized estimating equations to estimate the change in the prevalence of untreated caries over time. ResultsThe prevalence of untreated caries decreased by more than 50%: from 39% through 18% in phase 1, and from 28% through 10% in phase 2. The per-visit adjusted odds ratio of untreated caries was 0.79 (95% confidence interval, 0.73 to 0.85). Conclusions and Practical ImplicationsThis school-based comprehensive caries prevention program was associated with substantial reductions in children’s untreated caries, supporting the concept of expanding traditional practices to include office- and community-based aerosol-free care.

How effective are three methods of teaching oral hygiene for adolescents undergoing orthodontic treatment? The MAHO protocol: an RCT comparing visual, auditory and kinesthetic methods

BackgroundFixed orthodontic appliances hamper oral hygiene procedures. The consequences are gingivitis and white spot lesions. Fifty to 70% of patients treated with braces encounter these problems. Their care in the USA represents an annual cost of five hundred million dollars. Initial education and motivation for oral hygiene depend on two categories of factors: firstly, practical prophylactic measures (instruments and medication, professional care) and secondly, the educational component: choice of communication technique, frequency, and nature of hygiene instructions. This trial aims to study this last component. Its main objective is to compare three methods’ effectiveness of oral hygiene education in adolescent patients treated with braces in terms of biofilm (plaque) control. The secondary objectives are the evaluation of these methods’ effectiveness regarding gingival inflammation and the maintenance of hygiene during the first 6 months of treatment.MethodsThis study is a prospective randomized controlled trial of superiority. It evaluates the effectiveness of three hygiene education techniques. A total of 90 patients from the University Hospital Center of Rennes will be randomized into 3 parallel groups with a 1:1:1 ratio. Each will benefit from a different educational method: oral and/or practical. The main outcome will be the average plaque index for each group after 6 months of treatment. Additional outcomes will be the average gingival index for each group and the plaque and gingival indices over 6 months.DiscussionThe effectiveness of preventive procedures for optimizing oral hygiene during orthodontics is based on ambiguous literature. As a result, it is difficult to draw conclusions and to translate them into everyday practice. Sixty-eight percent of the orthodontists support the development of guidelines for education. The aim of this study is to standardize methods of oral hygiene education during orthodontic fixed treatment. The purpose of this study would be to provide practitioners with a concrete education program through guidelines dedicated to the method having the best results.Trial registrationClinicalTrials.gov NCT04444154. Registered on 22 June 2020. SI CNRIPH ID 8011N° 20.04.27.58337. Registered on 29 July 2020

INFLUENCE OF PERIODONTAL TREATMENT ON PRETERM BIRTH: SYSTEMATIC REVIEW AND META ANALYSIS

Background: Preterm birth is considered as the main cause neonatal mortality and morbidity[1]. The rate of preterm birth ranges from 5% to 18% of babies born in different countries[2].However, prevent, predict and delay this health condition is almost unsuccessful[2]. Millions of babies are born preterm and this number is rising[2]. Infectious diseases and local and systematic inflammation is most contributing factor to multifactorial etiology of this health condition[3]. The pregnant women are more susceptible to periodontal disease as it is the most prevalent chronic infectious disease in adult population[4]. There are 57 health condition related to periodontitis[5].The physical and hormonal alternation make the pregnant women more vulnerable to the periodontal disease. Relatively high prevalence of periodontitis during pregnancy found in different population, especially socio-economically disadvantaged women[4]. Periodontitis found to be a risk indicator for preterm birth outcome[6].Clinical trails were conducted to assess the effect of periodontal treatment during pregnancy on reducing these outcomes[7-25]. Objective: To assess the effect of different periodontal interventions during pregnancy on preterm birth outcome. Methods: A systematic review was conducted according to PRISMA guidelines[26], searching Cochrane Library, Pubmed and Embase databases up to 10 December, 2020. PICOS (Population, Intervention, Comparison and Outcomes, study design) framework was used as a search strategy tool. Intervention include scaling and root planning (SRP), Control oral hygiene instructions (OHI), Inclusion criteria were studied in pregnant women, including randomized controlled trials with the aim of assessing the effect of any periodontal treatments on preterm birth outcomes. Main outcome was perform birth(&lt;37 gestational week). The data were extracted from two authors and statistical analyses carried out using Review Manager (RevMan).

Practice with confidence: Analyzing confidence level of final year dental students from four Saudi dental colleges in Riyadh.

ObjectiveTo investigate the confidence level of final year dental students in Riyadh.MaterialsCross-sectional study was conducted at four dental colleges in Riyadh (N = 312, 220 and 70,5% responded). Oneway ANOVA and post hoc Tukey-Kramer was used.ResultsThe greatest self-reported confidence scores were for pit fissure sealent (4.6(0.7)). Whereas, students reported least confidence in conducting surgical extractions (2.7 (1.2)). Females were found more confident in conducting preventive resin restorations, oral hygiene instructions, and rubber dam placement as compared to male who were more confident in surgical extraction, copy dentures, veneer preparation and managing orthodontic emergencies.ConclusionAll students were confident in performing essential dental procedures however higher confidence was observed in performing simple procedures compared to more complex ones.

The Effectiveness of a Board Game-Based Oral Hygiene Education Program on Oral Hygiene Knowledge and Plaque Index of Adults with Intellectual Disability: A Pilot Study.

An oral hygiene board game was designed as an intervention tool and applied to explore the effectiveness for the oral health related knowledge (OHK) score and plaque index (PI) of adults with intellectual disability (ID). This one-group pre/post-test design study was conducted in a residential long-term care facility for 42 participants. The study had one pre-test (baseline) and three post-tests evaluated in both control and intervention stages, respectively. The participants participated in a 60-min oral hygiene board game twice a week during the intervention stage. Total OHK score and PI of the participants were recorded to determine the effectiveness of intervention. There were no differences in OHK score and PI between the two stages at baseline. The results in intervention stage demonstrated a significant gradual increase and reduction in the OHK score when compared with the control stage. A statistically significant improvement in the OHK score and PI (42.29% and −33.28%, respectively) at the end of intervention between two stages was recorded. This study proved a board game is deemed an effective education method applicable to promote the OHK and skills of ID adults.

Papillon Lefevre syndrome associated with recurrent pyogenic abscess of facial skin followed by scarring: A case report

Papillon-Lefévre syndrome (PLS) is an autosomal recessive disorder that is characterised by severe generalized early-onset periodontitis and palmoplantar hyperkeratosis. Besides these cardinal features some patients rarely exhibits recurrent pyogenic infections of skin, hair follicle infection (frunculosis), multiple abscess of skin, hyperhidrosis. This article represents a rare case of 17 year old young male patient with cardinal features of PLS along with history of recurrent pyogenic abscess of facial skin followed by scarring since childhood. There are multiple etiological factors like genetic, immunological, and microbial factors, consanguineous marriage and reduced host defense mechanism. Patients with PLS have increased susceptibility to infections. Over 300 cases have been reported till now in dental and medical literature with most of the cases discovered amongst Africans, Arabs and, Indians with 25% patients showing recurrent pyogenic infections. Management of the disorder primarily involves conventional periodontal treatment; oral hygiene instructions, antiseptic mouth rinses; and systemic antibiotic. Skin lesions are usually treated with topical application of emollients, keratolytic agents, steroids, and oral retinoid.

Efficacy of 1.23% acidulated phosphate fluoride gel on non-cavitated enamel lesions: a randomized clinical trial

A randomized controlled parallel clinical trial was conducted to evaluate the efficacy of the association of 1.23% topical professional acidulated phosphate fluoride (APF) gel with oral hygiene and dietary instructions on the arrest of active non-cavitated lesions in permanent, mixed, and temporary dentition in children between 3 and 12 years of age. Ninety-eight caries-active children were randomly divided into two groups: a fluoride gel group (n = 49) and a non-fluoridated gel group (n = 49). Each group received up to eight weekly applications of gel, weekly professional toothbrushing with oral hygiene instructions and dietary counselling. Caries lesions were assessed qualitatively through visual-tactile criteria performed in three stages: initial, intermediate, and final. Regression models were applied to identify risk indicators for caries control. Between-group comparison regarding the time taken to arrest the lesions was performed using Chi-squared and Fisher's exact tests. Seventeen children did not receive the allocated intervention, and one was lost to follow-up (n = 80). There was no difference between the control and placebo groups regarding the time to the arrest of the lesion (p >.05). The treatments showed similar results without significant statistical difference (p = 0.33; 95%CI: 0.32-1.48). No adverse effects were observed. It can be concluded that no additional effect of the association of 1.23% APF gel with oral hygiene using fluoride dentifrice and dietary instructions on the arrest of active non-cavitated lesions could be established. We can also confirm the importance of toothbrushing frequency and, consequently, the visible plaque reduction in the control of caries activity. RBR-37V5S3.

Does periodontal treatment have an impact on metabolic control and systemic inflammation in patients with type 2 diabetes?

Design Systematic review and meta-analysis.Data sources A search of two databases, Medline and CENTRAL, was undertaken, limited to articles published in English from the oldest records until 10 July 2018.Study selection Participants included patients diagnosed with type 2 diabetes and periodontitis, with HbA1c and C-reactive protein (CRP) measurements at baseline. The intervention was surgical or non-surgical periodontal therapy. The control was no periodontal treatment, supra-gingival scaling or oral hygiene instruction. The outcome was HbA1c and CRP measurements three months later.Data extraction and synthesis Two independent reviewers assessed articles initially by title and abstract, before reviewing full texts of relevant studies. Disagreements were resolved through discussion or a third reviewer. Data extraction included definition of periodontal disease, periodontal intervention and average changes in HbA1c and CRP. Risk of bias was assessed using the Cochrane Collaboration tool. Two meta-analyses were performed to determine the effects of periodontal intervention on HbA1c and CRP.Results Out of 402 potential studies, nine randomised controlled trials were included. Six studies had no periodontal treatment reported in the control arm, whereas oral hygiene instruction or supra-gingival scaling was described in three studies. The intervention in all studies was non-surgical periodontal treatment, but one also involved surgical debridement. No heterogeneity was detected using the Cochrane Q test or I2 statistic. The majority of studies were deemed to be at high risk of performance bias due to a lack of blinding of participants. The results of the meta-analyses indicated a significant reduction in percentage of HbA1c (difference in means = 0.56, 95% CI [0.36-0.75], p <0.00001) and in CRP levels (difference in means = 1.89, 95% CI [1.70-2.98], p <0.00001).Conclusions Periodontal treatment improves metabolic control as well as reduces systemic inflammation in patients with type 2 diabetes.

A cross-study to evaluate the effect of two methods of oral health education on the oral health status among visually impaired children

Objectives: Visually impaired children can encounter specific problems like plaque-associated disease which if untreated could result in higher risk. Despite this, there is not much available data authenticating the efficacy of oral health education aids using verbal commands and tactile sensations. Therefore, the present study was aimed to evaluate the use of oral health education aids using verbal instructions through audio and music-assisted toothbrushing system and oral hygiene instructions and brushing methods through braille among visually impaired children and its outcome on their oral health status. Study Design: This cross-sectional study included a total of 50 visually impaired children divided equally into music-assisted toothbrushing method and oral hygiene instructions and brushing method through braille's categories. Oral hygiene status was assessed using Simplified Oral Hygiene Index (OHI-S), gingival index (GI), and plaque index (PI) at different time intervals. Analysis was performed using Student's t-test, Mann–Whitney U-test, and Welch's t-test. Results: The OHI-S, PI, and GI scores significantly decreased at different time intervals for both the groups (P ≤ 0.001). Intergroup comparison regarding oral hygiene status between the braille and music groups at baseline to 6 months showed a significant improvement (P ≤ 0.001). Conclusions: The current study highlighted an improvement in the oral hygiene status with audio instructions and music-assisted toothbrushing system than braille. Employing these specially framed oral health educations improvised greatly the oral health status in visually impaired children.

The Effect of Visual Pedagogy and Probiotics in Improving Oral Hygiene of Hearing Impaired Children in the Age Group 6-14 Years

Introduction: Maintaining oral hygiene remains a priority in differently abled children. In recent times, probiotics usage has shown reduced disease causing oral microflora and promoting good oral hygiene. Aim: To assess the effect of visual pedagogy and probiotic mouth rinse on oral health of hearing impaired children. Methods: A prospective interventional study was done on hearing impaired children. The children were divided into three groups. Oral hygiene instructions were given using visual pedagogy, probiotic rinse and combination of both respectively. OHI and pH scores at each clinical visit (pre and post) were recorded. Statistical analysis of the observed data was done. Results: The difference in OHI and pH scores was statistically significant. Conclusion: Combination of both oral hygiene instructions using visual pedagogy and mouth rinse containing probiotics was found to produce desirable effects on oral health of hearing impaired children.

Efficacy of antioxidants therapy on progression of periodontal disease - A randomized control trial.

Increased oxidative stress has emerged as one of the prime factors in the pathogenesis of periodontitis. Hence, antioxidant therapy may become a promising tool in the treatment of periodontal disease. Uric acid is a major salivary antioxidant, levels of which decrease in periodontitis. The aim of the present study was to investigate the effect of antioxidant therapy on the progression of periodontal disease. This is a randomized controlled clinical trial conducted among 48 systemically healthy participants having generalized gingivitis with probing depth <3 mm, plaque index (PI) <1, and no bone and attachment loss. Participants were randomly assigned equally (n = 24) into two groups (test and control) using the lottery method. Full mouth scaling and root planing were performed in both the groups and oral hygiene instructions were given. Periodontal assessment at baseline 1 h after scaling and root planing was done with clinical parameters by a single examiner. Test group was prescribed; the commercially available anti-oxidant containing natural lycopene with green tea extract. Sample collection was done for both the groups at baseline and at the 45th day. It was observed that significantly high results were obtained during intra-group comparison for both modified plaque index and sulcus bleeding index from baseline to 45 days. After treatment, a very highly significant increase (P ≤ 0.001) in the test group and significant (P ≤ 0.05) increase in the control group were observed in salivary uric acid levels. Oral lycopene and green tea extract supplementation is positively associated with salivary uric acid levels and plays an important role in the management of gingivitis.

Effectiveness of instructed tooth brushing on plaque and oral hygiene among the visually impaired children from a residential blind school in Pune – An interventional study

Aim: The study was undertaken to evaluate the effect of instructed tooth brushing on plaque and oral hygiene among the visually impaired children from a residential blind school in Pune. Materials and Methods: An interventional study was conducted for 30 days at a residential Blind School for boys. Twenty-four blind children were recruited for the study. Baseline data were recorded using the modified patient hygiene performance (PHP) index and oral hygiene index-simplified (OHIS). Oral prophylaxis was undertaken. Oral health instruction pamphlet in Braille script was given to them. Supervised tooth brushing twice daily as per the musical audio instructions was performed for 30 days. Postintervention, the indices scores were recorded again. Paired t-test was used for comparison of pre and postintervention scores. Results: The modified PHP score pre and postintervention were 4.19 ± 0.54 and 1.81 ± 0.87, respectively, and the difference was statistically significant. The OHIS scores pre and postintervention were 3.31 ± 0.88 and 1.04 ± 0.54 and were also statistically significant. Conclusion: The present study revealed that the instructed tooth brushing program, along with oral prophylaxis and oral hygiene instructions in Braille for the visually impaired children for maintaining their oral hygiene is an effective method.

Should atraumatic restorative treatment be the preferred treatment for older patients?

Design Randomised controlled trial study.Case selection Ninety-nine subjects were chosen from 219 potential subjects. The 99 who met the inclusion criteria were randomly allocated to two treatment groups: atraumatic restorative treatment (ART) and conventional treatment (CT). To be selected, patients needed to be 65 years or over, follow oral hygiene guidance and have one or more painless dentinal carious lesions. To establish suitability, a full dental examination was performed by two calibrated dentists. Prior to receiving ART or CT, all participants received standard dental care (including extractions, non-surgical treatment and oral hygiene instructions). Following ART or CT, a dental nurse collected data regarding patient treatment preferences and a calibrated independent dentist, blind to the treatment allocation, reviewed restorations six months, one year, two years and five years after treatment.Data analysis The Cox proportional-hazards (PH) model was used to assess the cumulative survival of the variables ART and CT between the intervals. Bootstrapping was employed to estimate standard errors since the multiple restorations required by many patients were not necessarily independent of each other.Results Of the 99 subjects included, only 28 (ART: 15, CT: 13) remained after five years. After five years, of the 300 restorations undertaken, 15 ART restorations and 16 CT restorations failed. The cumulative probability of restoration survival was 85% and 79% (p = 0.8095) for ART and CT, respectively, with the Cox PH model showing the treatment used had no effect on the restorations' survival.Conclusions No significant difference was noted between the treatment methods used in terms of survival of the restorations. However, it is worth noting that 64.5% of participants preferred to have dental treatment without local anaesthesia and 71.1% without the use of a dental drill. Therefore, ART was a favourable treatment option in older patients, particularly those unable to attend the dental surgery.