Toothbrushing Sessions Research Articles

DENTAL CARIES PREVENTION THROUGH EDUCATION AND GIVING FLUORIDE FOR ELEMENTARY SCHOOL STUDENTS

Background: Dental caries among elementary school students remain high to this day. The occurrence of dental caries is often linked to poor oral hygiene, leading to damage in the tooth's hard tissues. A promotive and preventive approach is necessary, especially for elementary school students during the critical period of transitioning from primary to permanent dentition. Objective: This community engagement program aimed to improve dental hygiene and oral health among elementary school students through education, mass toothbrushing activities, and giving topical fluoride. Method: The methodology included dental hygiene and caries examinations, followed by educational sessions, mass toothbrushing activities, and the administration of topical fluoride to protect teeth from caries attacks. The evaluation of success is determined by comparing the oral hygiene index before and after the activity. Results: The evaluation results indicate that the educational outreach and mass toothbrushing campaign have had a positive impact on improving the overall oral hygiene levels of students. The number of students classified under the "good" category has increased, while those in the "fair" and "poor" categories have shown a decrease. Conclusion: The comprehensive approach, comprising dental health education, mass toothbrushing sessions, and the administration of fluoride during this community service initiative, has proven to yield positive benefits in enhancing the oral hygiene of students.

Oral health and emotional well-being in premenopausal and postmenopausal women: a cross-sectional cohort study

BackgroundMenopause, the absence of ovarian sex steroids, is frequently accompanied by emotional and physiological changes in a woman´s body, as well as oral health changes. The present study aimed to evaluate the association between the periodontal health status and emotional and physical well-being among postmenopausal women (PMW) in comparison with regularly menstruating premenopausal women (RMPW).MethodsA total of 115 women (PMW, n = 56, mean age ± SD: 54 ± 5; RMPW, n = 59, mean age ± SD: 41 ± 4) received a comprehensive medical assessment and a full-mouth oral examination. All completed the Women’s Health Questionnaire (WHQ) to measure emotional and physical well-being. The corresponding bone mineral density (BMD) scores were obtained from participants´ medical records.ResultsTooth loss was significantly higher in PMW than RMPW after adjusting for age (3.88 ± 2.41 vs 2.14 ± 2.43, p < 0.05). No significant difference was found in the prevalence of periodontitis between the two groups (PMW: 39.2%, RMPW: 32.2%, p > 0.05). The prevalence of periodontitis was associated with fewer daily brushing sessions in PMW (p = 0.021). Based on the WHQ, both PMW and RMPW with periodontitis had higher ‘’depressed mood’’ scores compared to periodontally healthy women (p = 0.06 and p = 0.038, respectively). The women who reported fewer daily toothbrushing sessions found to have higher depressive mood scores (p = 0.043).ConclusionsPresence of periodontitis is associated with the emotional and physical well-being of women and reinforcement of oral healtcare is recommended at different stages of a woman’s life including menopause to reduce the risk for early tooth loss in women.

Evaluation and Acceptance of an Electric Toothbrush Designed for Dependent Patients.

Introduction: A key barrier to standardizing evidence-based oral health protocols for highly dependent patients is the lack of validated and accepted oral health products designed specifically for use by caregivers. This study compared preferences by users of a novel electric toothbrush and a manual toothbrush in a health care setting.Methods: We prospectively enrolled health care providers as volunteers. Volunteer brushers completed simulated tooth brushing sessions of mock-intubated and non-intubated volunteer brushees with both toothbrushes. Volunteers rated different domains of toothbrush preference in an anonymous, optional survey.Results: A total of 133 health care providers volunteered (123 brushers [providers brushing teeth] and 10 brushees [those having their teeth brushed]). The novel electric toothbrush received significantly higher positive ratings than the standard hospital-issue manual toothbrush in all domains that we surveyed: ease of use, thoroughness, safety, shape and size of the brush head, overall cleanliness, time requirements, and efficiency (p<0.001). Importantly, due to the integrated light and suction of this electric toothbrush, brushers completed more sessions without setting down the toothbrush with the electric toothbrush than with the manual toothbrush (75.4% vs 36.4%; p<0.001).Conclusions: Integrating a lighted electric brush with suction into the caregiver’s armamentarium as an evidence-based tool is warranted and should be evaluated in terms of patient outcomes.

Data on toothbrushing study comparing infrared-based motion tracking versus video observation.

Investigations of toothbrushing habits are an important vector to understand their influence on brushing effectiveness. User compliance in toothbrushing is known to deviate from professional recommendations in brushing time, evenness across all areas of the dentition, and brushing force [1,2]. Despite the recent development of tools designed to guide users to optimised brushing habits [3,4], research on habit evaluation and tracking is limited and typically relies on labour-intensive video observation (VO) [5]. Here we present raw data on toothbrush position as determined by an automated motion tracking (MT) capability and by human VO and provide a technical description of the MT capability. The MT system described in this article was developed in collaboration with Soft2Tec GmbH (Rüsselsheim, Germany) as a potential substitute for the VO tool. The MT system consists of a monocular vision module and a target module with active infrared LED trackers. The MT system determined the position and orientation of a toothbrush relative to the jaw while subjects brushed under realistic conditions. For VO, a trained assessor coded video recording data from toothbrushing sessions. The data presented here describes a clinical study (103 subjects; 46 completed two sessions, 57 completed one session, altogether 149 events) comparing toothbrushing behaviour recorded with the MT system and with VO simultaneously. The raw data was deposited in Mendeley Data, under data identification number doi:10.17632/4f384xrbhm.1 [https://data.mendeley.com/datasets/4f384xrbhm/1].

Relationship between oral health behaviour and handgrip strength: a cross-sectional study with 7589 Korean adults

Objective: This cross-sectional study investigated the relationship between handgrip strength and oral health behaviours among Koreans.Methods: The data of 7589 individuals (3384 men and 4205 women) aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2014–2015 were analyzed. Oral health behaviour was assessed based on the number of daily toothbrushing sessions and the use of secondary oral-care products. The association between oral-health behaviour and handgrip strength was investigated adjusting for confounders. Multivariable logistic regression analysis was performed (α = 0.05).Results: The proportion of participants diagnosed with sarcopenia was significantly higher in the group with poor oral-health behaviours. After adjusting for confounders including age, the adjusted odds ratios and 95% confidence intervals of female participants with low handgrip strength in groups toothbrushing thrice or more per day, twice per day, and once or less per day were 1 (reference), 1.18 (0.99–1.4), and 1.24 (0.89–1.71), respectively. There were significantly more participants with low handgrip strength in the group that did not use secondary oral products for both sexes.Conclusions: Oral health behaviour is associated with handgrip strength among adults. Poor oral self-care habits may constitute a risk indicator for low muscle strength.

Effect of using an intra-oral camera as a reinforcement tool for plaque control in a supervised toothbrushing program: An interventional study

Introduction: Supervised toothbrushing program at schools have indicated limited improvement in oral hygiene among children. Aim: The aim of this study is to evaluate whether the use of an intra-oral camera as a reinforcement tool in a supervised tooth brushing program at school can improve plaque control. Materials and Methods: A double-blind, parallel, two arm interventional study was conducted among 120 school children from 2 schools, aged 12-year in Pune. The study group received an intervention of supervised toothbrushing and reinforcement sessions for 30 days using intra-oral camera. The control group received only supervised toothbrushing. Evaluation for plaque control was performed at the end of 30 days, 3 months, 6 months, and 12 months. Analysis of co-variance was used to find the intergroup difference at different time intervals. Analysis of variance was used to find the intragroup differences of the plaque scores. Post hoc Bonferroni test was used to find the pairwise changes in plaque scores between different time intervals. Results: In the study group, the mean plaque score was reduced to a significant extent from baseline to 30 days and 3 months (P < 0.05) and then the plaque score remained stable until the end of 12 months. While in the control group, the plaque score increased compared to baseline. There was a statistically significant difference between the mean plaque scores of study and control group at each time interval (P < 0.05). Conclusion: Intra-oral camera can be effectively used as a reinforcement tool in supervised toothbrushing program at school for achieving higher plaque reduction.

Influence of scheduling in clinical dental care on indicators of oral health

Objective: Assess the oral health indicators in the Family Health Units (Unidades de Saúde da Família - USFs) with scheduled demand in comparison with Family Health Units with spontaneous demand in oral health care, in Piracicaba. Methods: 10 Family Health Units located in Piracicaba, were randomly chosen: 5 Units with spontaneous demand and 5 Units with scheduled demand. Secondary data in daily production spreadsheets were collected from the information system, from February to September 2013. These were organized into indicators: 1) access; 2) resolutivity; 3) ratio of dental emergency per inhabitant; 4) mean number of individual preventive and curative dental procedures; 5) ratio of dental extraction per dental procedure; 6) ratio of dental extraction per inhabitant; 7) mean number of supervised toothbrushing sessions. Data were compared and statistically analyzed with the BioStat 5.0 program, by applying the Student's-t test (p ≤ 0.05). Results: There were significant differences in the indicators of dental emergency, dental extraction per clinical procedure, and dental extractions per inhabitant, and these values were higher in Family Health Units with spontaneous demand. Conclusion: The model of scheduling the demand for dental care adopted by the USFs interferes in the number of users seeking dental emergency treatments and reasons for extractions.

Evaluation of a pilot oral health promotion programme 'Keep Smiling': perspectives from GDPs, health champions and school staff.

To evaluate a pilot oral health promotion programme (fluoride varnish and tooth brushing), targeting 3-7-year-olds in primary schools in a deprived area of London. A pilot programme was conducted among five primary schools targeting 3-7-year-old children in a deprived area of London. The programme consisted of a fluoride varnish application and tooth brushing sessions. Outcome (participation rates) and process evaluations were carried out using semi-structured interviews with school staff, health champions and dentists. Overall, 79.2% of the targeted children participated in tooth brushing and 68.6% of children received fluoride varnish. The programme received positive feedback from school staff, dental teams and health champions. It raised awareness of dental health among all stakeholders and provided children with a unique experience, creating a positive image of dental teams. Community engagement and collaboration between health, education and the voluntary sector is feasible and integral in developing oral health promotion programmes aimed at children attending primary schools in a deprived area of London.

Quantitative analysis of formal caregivers’ use of communication strategies while assisting individuals with moderate and severe Alzheimer's disease during oral care

This cross-sectional observational study examined formal caregivers’ use of task-focused and social communication strategies while assisting individuals with moderate and severe Alzheimer's disease residing in a long-term care facility during a basic activity of daily living: toothbrushing. Thirteen formal caregiver–resident dyads were observed during a total of 78 separate toothbrushing sessions. All caregiver utterances occurring during the task were transcribed and coded for type of communication strategy utilizing a multidimensional observational coding scheme, which was developed a priori. Overall, the majority of residents, irrespective of disease severity, successfully completed toothbrushing with the support of caregiver assistance. Caregivers assisting residents with moderate and severe AD were found to use a variety of communication strategies, with task-focused strategies accounting for the majority of use. For the most part, the communicative strategies employed did not differ across disease severity. However, some differences were identified including the use of one proposition, paraphrased repetition, using the resident's name, and provision of full assistance, with these strategies being used more often when assisting individuals with severe AD.This study adds to the emerging literature supporting the use of specific communication strategies while assisting residents with AD during the completion of daily tasks.Learning outcomes: From reviewing this study, readers will be able to identify a variety of communication strategies, both task-focused and relational, that formal caregivers utilize while assisting residents with moderate and severe Alzheimer's disease (AD) during a basic activity of daily living. Furthermore, the reader will be able to distinguish between communication strategies that are optimal when assisting individuals with moderate AD as compared to assisting individuals with severe AD.

Effect of toothbrush grip on plaque removal during manual toothbrushing in children

Toothbrushing is fundamental to oral hygiene. Children differ in manual dexterity and their grip on toothbrushes. We videotaped toothbrushing sessions and observed the grip type, duration of brushing, and brushing technique used among 100 children aged 8-12 years. We then investigated the association between grip type and plaque removal, using plaque scores obtained at various time points. We further examined the effect on plaque scores of standardizing both brushing technique and duration among the same participants. The most common grip was the distal oblique, followed by the oblique; the spoon and precision grips were rare, and no child used a power grip. Mean brushing duration for most children was 1.43 ± 0.85 min, and the most common brushing technique was horizontal scrubbing. We conclude that grip preference is inherent and that the distal oblique grip was better than the oblique grip in removing plaque.

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.

A study to test the feasibility of distributing toothpaste and toothbrushes at school

Objective To test the feasibility of a school based method of delivery of toothbrushes, toothpaste and tooth brushing instruction to first year primary school children. Design Pre and post examinations of children's mouths, pre and post questionnaires to parents and a questionnaire to teachers at the end of the study. Setting In five schools in a unitary authority in Lancashire, UK. Method Examination of the mouth at school, using dental caries criteria used in the NHS national dental epidemiological programme and the Silness and Loe Plaque Index, and questionnaires distributed via school to parents and teachers. Results One hundred and seven children were examined twice and parents returned 57 questionnaires. During the toothbrushing sessions many children said that they did not have a brush or paste. They enjoyed taking part and the examinations revealed that their mouths were cleaner after the study than they were at the beginning. The scheme was acceptable to parents and schools. All schools wished to carry on their involvement in the project. The cost of providing the scheme to 500 children in schools with the highest levels of tooth decay was estimated to be about £4350 per annum. Conclusion A similar programme is worth considering in areas where the levels of tooth decay are known to be high.

Effect evaluation of an oral health education programme in primary schools in Tanzania.

This study aimed to assess the clinical oral health outcome effects among schoolchildren participating in a school-based oral health education (OHE) programme. Local social, cultural and environmental conditions were determinants of the school-based OHE programme, which was compiled on the basis of prevailing beliefs and on what teachers and educational authorities considered to be important for the oral health of schoolchildren. Consequently, the practical aspects of oral hygiene and information on the cause and prevention of caries and gingivitis were the components of oral health education. The teachers were prepared to carry out weekly supervised toothbrushing sessions and monthly lessons on aspects of oral health for the school year in grade 4. Eight participating schools were selected for the clinical effect evaluation and four non-participating schools served as the control. In total, 309 children from the participating schools and 122 children from the non-participating schools were available for the evaluation. Their ages varied between 9 and 14 years. The mean plaque score, calculus score and gingival bleeding score at baseline and at follow-up examinations 3, 8, 15 and 36 months later were not significantly different for participating schools and controls. The mean DMFT value at baseline was 0.4 and 3 years later 0.9 in both the participating and control schools. In conclusion, the present study shows that the implemented school-based OHE programme did not result in significant reductions of the clinical parameters measured.

An institutional staff training and self-management program for developing multiple self-care skills in severely/profoundly retarded individuals.

Although considerable attention has been given to the development of institutional staff training and management programs, the generalized effects of such programs on staff and resident behavior have seldom been examined. This study evaluated a program for teaching institutional staff behavioral training and self-management skills during self-care teaching sessions with severely and profoundly retarded residents. Following baseline observations in three self-care situations (toothbrushing, haircombing, handwashing), four direct care staff were sequentially taught to use verbal instruction, physical guidance, and contingent reinforcement in the toothbrushing program. During maintenance, staff were simultaneously taught to record, graph, and evaluate resident and their own behavior in the toothbrushing sessions. Staff were taught use of the training and self-management skills through a sequence of written instructions, videotaped and live modeling, rehearsal, and videotaped feedback. Observer presence and experimenter supervision were gradually decreased during the maintenance condition. Results indicated that during training and maintenance staff: (a) learned to use the training skills appropriately and consistently in the example situation (toothbrushing); (b) applied the skills in the generalization situations (haircombing and handwashing); and thereafter (c) maintained consistent and appropriate use of the skills with infrequent supervision. In addition, important changes in retarded residents' independent self-care responding occurred as staff training skills developed. Results are discussed in terms of their implications for future research and continued development of effective staff training and management programs.

The effects of modelling on the contingent praise of mental retardation counsellors.

A multiple-baseline design was used to evaluate the effects of a simple modelling procedure on the contingent praise of five counsellors while they conducted hygiene-training sessions in toothbrushing and hand-and-face washing with severely retarded children. After varying numbers of baseline sessions, each counsellor watched a model who conducted a series of toothbrushing sessions, in which he conspicuously praised correct toothbrushing responses and approximations to correct responses. No modelling occurred during hand-and-face washing sessions. As a result of several exposures to the model's performance, levels of response-contingent praise provided by four of the five counsellors during toothbrushing sessions increased sharply over baseline. The levels of counsellor praise showed parallel increases during hand-and-face washing sessions. A two-week followup showed that the levels of praise obtained through modelling were maintained in the model's absence.