Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized controlled trial

Abstract

BackgroundSupervised toothbrushing programs using fluoride dentifrice have reduced caries increment. However there is no information about the effectiveness of the professional cross-brushing technique within a community intervention. The aim was to assess if the bucco-lingual technique can increase the effectiveness of a school-based supervised toothbrushing program on preventing caries.MethodsA randomized double-blinded controlled community intervention trial to be analyzed at an individual level was conducted in a Brazilian low-income fluoridated area. Six preschools were randomly assigned to the test and control groups and 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice supervised directly by a dental assistant, was developed four times per year. At the remaining school days the children brushed their teeth under indirect supervising of the teachers. In test group, children also underwent a professional cross-brushing on surfaces of first permanent molar rendered by a specially trained dental assistant five times per year. Enamel and dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars during 18-month follow-up. Exposure time of surfaces was calculated and incidence density ratio was estimated using Poisson regression model.ResultsDifference of 21.6 lesions per 1,000 children between control and test groups was observed. Among boys whose caries risk was higher compared to girls, incidence density was 50% lower in test group (p = 0.016).ConclusionModified program was effective among the boys. It is licit to project a relevant effect in a larger period suggesting in a broader population substantial reduction of dental care needs.Trial registrationISRCTN18548869.

A Comparative Evaluation of Efficacy of Different Teaching Methods of Tooth Brushing in Children Contributors

“…On the other hand in Group III (child as a model), the model was chosen randomly amongst the selected children, who could probably not portray correct brushing technique. Frazao P did a study to assess if the bucco-lingual technique can increase the effectiveness of a school-based supervised toothbrushing program on preventing caries and concluded that modified program was effective among the boys [16]. It is licit to project a relevant effect in a larger period suggesting in a broader population substantial reduction of dental care needs.…”

Epidemiology of dental caries: when structure and context matter

“…15 Systems for monitoring, surveillance and evaluation of populationwide strategies related to fluoridated water, salt and toothpastes must be maintained. In addition, it is important to improve the community-based oral health programs on caries prevention among children 16 and teenagers in order to redirect the activities undertaken by upper level professionals toward other population groups.…”

Custo-efetividade da escovação dental supervisionada convencional e modificada na prevenção da cárie em molares permanentes de crianças de 5 anos de idade

“…Além disso, um estimador conectado ao número de superfícies no intervalo de tempo sujeito ao risco foi empregado. Conforme discutido em artigo publicado anteriormente 11 , para controlar a precisão das estimativas, uma variável ligada ao risco de cada indivíduo foi acrescentada em modelo multivariado empregado para avaliar taxas de incidência, levando, em consideração, a variação subindividual e entre os sujeitos das unidades de teste e de controle.…”

“…Nos demais dias letivos, escovação diária, supervisionada indiretamente pelos professores, foi realizada no pátio coberto da escola. Nas unidades de teste, além dessa atividade convencional, o auxiliar de saúde bucal foi capacitado para aplicar, nos molares permanentes em erupção, tanto superiores quanto inferiores, a técnica de escovação vestíbulo-lingual usando a escova do participante 11 . Estudos de base clínica têm mostrado a eficácia da remoção da placa bacteriana nas superfícies de molares permanentes em erupção por meio dessa técnica 12,13,14 .…”

“…A fim de explorar diferenças nas característi-cas do grupo de teste e de controle no início da intervenção, testes paramétricos e não paramé-tricos foram usados, e os resultados foram publicados em outro artigo 11 . O número de superfí-cies expostas e o tempo de exposição (em meses) foram calculados, em cada seguimento, desde o último exame.…”