Improving Oral Hygiene Skills by Computer-Based Training: A Randomized Controlled Comparison of the Modified Bass and the Fones Techniques

Abstract

BackgroundGingivitis and other plaque-associated diseases have a high prevalence in western communities even though the majority of adults report daily oral hygiene. This indicates a lack of oral hygiene skills. Currently, there is no clear evidence as to which brushing technique would bring about the best oral hygiene skills. While the modified Bass technique is often recommended by dentists and in textbooks, the Fones technique is often recommended in patient brochures. Still, standardized comparisons of the effectiveness of teaching these techniques are lacking.Methodology/Principal FindingsIn a final sample of n = 56 students, this multidisciplinary, randomized, examiner-blinded, controlled study compared the effects of parallel and standardized interactive computer presentations teaching either the Fones or the modified Bass technique. A control group was taught the basics of tooth brushing alone. Oral hygiene skills (remaining plaque after thorough oral hygiene) and gingivitis were assessed at baseline and 6, 12, and 28 weeks after the intervention. We found a significant group×time interaction for gingivitis (F(4/102) = 3.267; p = 0.016; ε = 0.957; η2 = 0.114) and a significant main effect of group for oral hygiene skills (F(2/51) = 7.088; p = 0.002; η2 = 0.218). Fones was superior to Bass; Bass did not differ from the control group. Group differences were most prominent after 6 and 12 weeks.Conclusions/SignificanceThe present trial indicates an advantage of teaching the Fones as compared to the modified Bass technique with respect to oral hygiene skills and gingivitis. Future studies are needed to analyze whether the disadvantage of teaching the Bass technique observed here is restricted to the teaching method employed.Trial RegistrationGerman Clinical Trials Register DRKS00003488

Tooth Brushing Techniques

“…But our result is contrast with Hernacke D et al, who found Fones method superior in removing plaque as compared to modified Bass technique. 18 Our results are in accordance with Robinson, who found Bass technique as most effective in the plaque removal.…”

Training in different brushing techniques in relation to efficacy of oral hygiene in young adults: a randomized controlled trial

“…, Hoffmann , Harnacke et al. , b), oral cleanliness was far from perfect after participants had been asked to perform oral hygiene to the best of their abilities. Thus, at the end of the long years of prophylactic efforts sustained by public authorities, these young adults appear to be unable to cleanse the majority of their gingival margins of adjacent plaque.…”

“…, Harnacke et al. ,b) was assessed immediately after participants had been asked to clean their teeth to the best of their abilities (toothbrush, tooth paste and dental floss were provided). The MPI monitors stained (Mira‐2‐tone ® ‐solution; Hager & Werken, GMBH & Co, Duisburg, Germany) plaque deposits next to the gingival margin as present or absent.…”

“…, Hoffmann , Harnacke et al. , b). Several brushing techniques have been described, which are considered to help patients to remove plaque effectively.…”

Using smartphone video “selfies” to monitor change in toothbrushing behavior after a brief intervention: A pilot study

“…[31] As well, sensor-based toothbrushes, another direct method of evaluation, are available and increasingly provide intricate details of TB. Notably, the newly emerging smart toothbrushes [34–38] such as those by Oral-B™ (http://oralb.com/en-us/product-collections/bluetooth) which uses sensors and the Prophix toothbrush (https://www.getprophix.com) which uses cameras and a view screen are compatible with and could enable new advantages for our approach.…”