Tooth Brushing Activities Research Articles

Tooth-Brushing Practices of Parents and Toddlers: A Study of Home-Based Videotaped Sessions

The aim of this pilot study was to investigate the tooth-brushing behaviour of parents and toddlers, by analysis of tooth-brushing sessions videotaped in families’ homes. Eighteen families (self-selected from an ongoing preventive-intervention study) videotaped all home tooth-brushing sessions involving their toddler (average age 2.5 years) over a 24-hour period. The vast majority of families (89%) engaged in at least two sessions per day, usually supervised by mothers. The average length of the sessions was 142 s, although the brush tended to be in the child’s mouth for less than half of that time. On average, only 10 s were spent brushing the front teeth, 13 s the back teeth, and 29 s spent on non-brushing activities (e.g., biting brush, sucking water). Three styles of brushing were identified, and families tended to be consistent in their use of these styles: exclusively parent-led (least common), exclusively child-led, and shared between parent and child (most common). In contrast with these poor behavioural outcomes, feedback from parents indicated that they were generally confident that the sessions had been effective in achieving clean teeth. These findings suggest that home-based tooth-brushing activity falls far short of professional expectations. Tooth-brushing, even with fluoride toothpaste, may be seriously compromised as a method of reducing caries in toddlers because teeth are being brushed too briefly.

Effectiveness of an oral health education and caries prevention program in kindergartens in China

To evaluate the effect of a 2-year oral health education and caries prevention program implemented in kindergartens in China. Seven hundred and thirty-one 3-year-old children were recruited from 10 kindergartens in Miyun County, Beijing, China. The kindergartens were randomly divided into two groups. Oral health education was provided to teachers in the test kindergartens every 3 months. Oral health education sessions were conducted for the test children monthly and for their parents semiannually. Children in the test kindergarten brushed their teeth twice daily with fluoridated toothpaste (1100 ppm F-) in their kindergarten under the supervision of teachers during weekdays. No oral health education session and no supervised tooth brushing activities were carried out in the control kindergartens. A clinical examination of the study children and a questionnaire survey of their parents were conducted at baseline and after a 2-year program. Five hundred and fourteen children remained in the study after 2 years. The mean caries increments of the test group (n = 258) and the control group (n = 256) were 2.47 and 3.56 dmfs, respectively. The reduction in dmfs increment was 30.6% (P = 0.009). At the evaluation, a significantly higher percentage of children in the test group than in the control group reported brushing their teeth twice a day (87.6% vs. 69.0%; P < 0.001). Parents of children in the test group had better oral health knowledge and attitude than the parents of children in the control group. This oral health education program was effective in establishing good oral health habits among preschool children and in increasing oral health knowledge of their parents, in conjunction with supervised daily tooth brushing with fluoridated toothpaste, which could reduce the development of new dental caries in preschool children in China.

Short and long term evaluation of changes in oral cleanliness, following repeated dental health education in high risk schools in Rochdale, England

Schools showing a high percentage of pupils needing referral for dental treatment following the last full dental inspection were targeted for intensive dental health education. The aims of the study were to improve the ability of children, from schools where the dental status is known to be poor, to clean their teeth effectively, and to evaluate any improvements in cleanliness following the implementation of repeated dental health education teaching module(s), and finally to discover whether actual cleanliness reflected reported brushing activity. All children were tested at baseline. The schools were divided into three groups: a control group and two test groups. One test group received intensive dental health education twice in a school year; the second test group received dental health education every term over a school year. These groups were again tested with the control. The control then received dental health education (once) and, one year on, all three groups were retested. At short term evaluation, both test groups scored higher on cleanliness than the original control, but those who received dental health education every term were very much cleaner.At the long term follow-up, there was no significant difference between the groups, however all three groups had retained improved cleanliness over baseline levels. Cleanliness of teeth matched well with reported toothbrushing activity in the morning. The study, initially, had been intended as a randomised control trial. However, the head teachers of schools randomly assigned as ‘controls’ refused, on the grounds that they considered it unethical to withhold dental health education from children who have high levels of dental disease. This study highlights the problems of following the ‘Medical Model’ of scientific study when applied to ‘population’ studies in the real world.