An intervention programme to establish regular toothbrushing: understanding parents’ beliefs and motivating children

Abstract

Aims/Objectives: To determine the benefit of twice daily toothbrushing on newly erupted first permanent molars. To investigate, through the Health Belief Model, how parents' beliefs influence the likelihood of their children brushing twice a day. To identify aspects of a toothbrushing intervention programme that can be used in general dental practice. Design: Randomised controlled trial. Setting: Schools in deprived communities in Scotland. Participants: 461, 5‐year‐old children. Interventions/methods: Supervised toothbrushing on schooldays with a 1,000ppm chalk‐based fluoride toothpaste for two years. A school and home‐based incentive scheme including toothbrushing charts, 6‐monthly dental examinations and parental questionnaires. Main outcome measures: Caries increment and twice daily toothbrushing. Results: In the control group, children who brushed once a day or less had 64% more caries than those who brushed at least twice a day (P=0.001). In the intervention group this difference in caries was reduced to 16% (P>0.05). The most significant parental belief explaining variation in twice‐daily brushing was whether parents feel strongly that there is time to check their child's toothbrushing (P=0.0001). The odds of these parents reporting that their child brushes twice daily are nearly three times greater. 95% of parents felt that toothbrushing charts would be a good way for dentists in practice to encourage children to brush regularly. Conclusions: The benefit of twice daily toothbrushing on caries development in newly erupted first permanent molar teeth is around 50% compared to brushing once a day or less. Parents' beliefs do influence the likelihood of their children brushing twice a day. Key parts of the intervention programme can be used when children attend general dental practice and would be welcomed by parents.

Impact of Educational Interventions Based on the Implementation Intentions Strategy on the Oral Health of Schoolchildren

“…Other hypothesis for the lack of statistically significant difference in GBI and a not very evident difference in PI, as well as 2 in correct and wrong answers of groups IG1, IG2 and CG, may have been the impact of the educational methodology initially used in the three groups, which has been based on exercise of participation of children and use of educational resources that stimulate empathy of children to the subjects proposed, with the use of characters considered relevant to them and, therefore, different from interventions proposed in literature, which are primarily focused on cognitive contents of oral health, using illustrations and models meaningless to children and use of passive learning methodologies [2,13,15].…”

“…Classes were randomized into three groups according to methodology proposed by Pine [13]: Control Group (CG) = 73 children; Intervention Group 1 (IG1) = 58 children and Intervention Group 2 (IG2) = 47 children. The sample size was considered appropriate to test a strong effect with 5% significance and 80% power in the ANOVA model with 3 comparison groups.…”

“…In addition, children from all groups answered a questionnaire about basic oral health knowledge with 9 multiple choice questions developed from previous studies [13,15], including topics such as oral self-care, tooth brushing frequency, use and importance of dental floss and eating habits, assigning score 1 for right answers and 0 for wrong answers. To investigate the comprehension of instrument questions by children, a pilot test was carried out with a sample of 15 schoolchildren of the same schools.…”

“…For that, parents of children form GI2 group attended a lecture about theory and information proposed to children and they were recommended to monitor or observe at least the last brushing of the day, at night, before children go to sleep [12,13].…”

Clinical trials in dental primary care: what research methods have been used to produce reliable evidence?

“…These included reimbursement for work done 14,24 seminars and academic detailing 16,41 supply of materials 15 intense training sessions 10,28,47,31,31 and the provision of dedicated research staff. 14,18,22,42,48,52 …”