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J Int Soc Prev Community Dent. 2014 May-Aug; 4(2) 11!"11#.

$oi 10.410!%22!1-0.1!'!0

PMCID PMC41&04!

Effectiveness of different tooth brushing techniques on the removal of dentalplaque in 6–8 year old children of Gulbarga

Smita P. Pati* Pra+,ant . Pati*1 an$ Meena . /a+,etty2

Corresponding author: (emai moc.iamg#0itaatim+r$3) Dr. Smita P. Pati*

Deartment o Pe$o$ontic+ an$ Preventive Denti+try* S. 5i6aingaa Coege o

Denta Science+* Se$am 7oa$* 8u9arga - ' 10!* /arnata:a* In$ia.

Coyrig,t Journa o Internationa Society o Preventive an$ Community Denti+try

,ic, ermit+ unre+tricte$ u+e*

$i+tri9ution* an$ rero$uction in any me$ium* rovi$e$ t,e origina >or: i+ roery

cite$.

Abstract

Obective:

This study was undertaken to evaluate the respective effectiveness of the horizontal scrub,

Fones, and modified Bass methods demonstrated on the cast to individual child within the

classroom setting.

!aterials and !ethods:

A total of 1! healthy children studying in 1st and "nd grades in the age range of #$ years

were randomly selected from various schools of %ulbarga district, &arnataka, 'ndia. They

were e(ually divided into three groups. )hildren in each group were demonstrated only one

of the three brushing techni(ues, viz. horizontal scrub techni(ue to group A, Fones techni(ue

to group B, and modified Bass techni(ue to group ), using a cast model. All the children

were re$e*amined and reviewed after "+ h and pla(ue inde* was re$assessed to obtain the

follow$up data. The results were compared with the baseline data, and statistical analysis was

http://dx.doi.org/10.4103%2F2231-0762.138305http://www.ncbi.nlm.nih.gov/pubmed/?term=Patil%20SP%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Patil%20PB%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Kashetty%20MV%5Bauth%5Dmailto:dev@nullhttp://www.ncbi.nlm.nih.gov/pmc/about/copyright.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Patil%20SP%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Patil%20PB%5Bauth%5Dhttp://www.ncbi.nlm.nih.gov/pubmed/?term=Kashetty%20MV%5Bauth%5Dmailto:dev@nullhttp://www.ncbi.nlm.nih.gov/pmc/about/copyright.htmlhttp://dx.doi.org/10.4103%2F2231-0762.138305


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carried out using paired t$test and intergroup comparison was made using analysis of variance

A-/A0 test.

"esults:

tatistically significant P 2 !.!!10 reduction in pla(ue score was seen in modified Bass

techni(ue followed by horizontal scrub techni(ue and the least efficacy was seen in Fones

techni(ue.

Conclusion:

This study showed that modified Bass techni(ue was the most effective brushing techni(ue in

children.

Keywords: Children, dental plaque, tooth brushing techniques

#$%"O&'C%#O$

The most common dental problem of concern in school going children is dental caries. The

reported prevalence of dental caries in #$year$old children in &arnataka is 34."!5.617 8ental

pla(ue is considered as the possible causative agent of the ma9or dental diseases such as

caries and periodontal disease. :la(ue as an etiologic agent was first identified in a classic

study by ;oe et al . in 1


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#nclusion criteria

• i0 @ealthy children between the age group of #$ years

• ii0 )hildren who were co$operative with no physical and mental disability

• iii0 )hildren ready to participate in the study.

E+clusion criteria

• i0

)hildren with orthodontic or prosthodontic appliances

• ii0

)hildren with caries, periodontal involvement, and oral infections.

Before the commencement of the study, permission was obtained from the concerned school

authorities. The procedure was fully e*plained to the parentsguardians of all the children

involved in the study and their informed consent was obtained prior to the study. At the

beginning of the study, a detailed (uestionnaire was used to collect information regarding

personal details and oral hygiene practices including the brushing techni(ue. ral

e*amination was performed under natural daylight using a mouth mirror with good reflecting

surface and dental e*plorer. The teeth were dried and isolated with cotton rolls, and

disclosing solution :;A& pla(ue disclosing solutionC '):A Danufacturers, Dumbai,

'ndia0 was applied. The children were asked to rinse with water to disclose pla(ue prior to the

pla(ue inde* recording. Assessment of pla(ue using illness and ;oe pla(ue inde*637 was

carried out in all the children to obtain the baseline data. All the children were provided with

9unior tooth brush and tooth paste of a standard company. These children were further

randomly divided into three groups group A, group B, and group )0 of #! children each.

8emographic details of the children in each group are shown in Table 1. )hildren in each

group were demonstrated only one of the three brushing techni(ues, viz. horizontal scrub

techni(ue in group A, Fones techni(ue in group B, and modified Bass techni(ue in group ),

using a cast model. )hildren were later asked to brush their teeth using the techni(ue

demonstrated to them in front of mirror, which was supervised. They were recommended to

brush their teeth twice daily once in the morning after having their milktea and once at night before going to bed. All the children were re$e*amined and reviewed after "+ h and pla(ue

inde* was re$assessed to obtain the follow$up data. The results were compared with the

baseline data and statistical analysis was carried out using paired t $test and intergroup

comparison was made using analysis of variance A-/A0 test.

"E)'(%)

:la(ue scores were individually compared at baseline and "+$h follow$up in each group using

paired t $test. :la(ue scores in group A horizontal scrub techni(ue0 reduced from baseline

score mean E 1.""0 to follow$up score mean E !.#+=0, which was statistically significant

P 2 !.!!10 6Figure 17. :la(ue scores in group B Fones techni(ue0 reduced from baseline

score mean E 1."


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reduced from baseline score mean E 1."4+0 to follow$up score mean E !.++3#0, which was

statistically significant P 2 !.!!10 6Figure =7.

)omparison was made between the three groups for pla(ue scores at baseline and "+$h

follow$up 6Figure +7 and the results were analyzed using single A-/A test. Baseline pla(ue

scores of all the three groups were comparable, with no significant intergroup differences.@owever, statistically significant P 2 !.!!10 reduction in pla(ue score was seen in modified

Bass techni(ue followed by horizontal scrub techni(ue and the least efficacy was seen in

Fones techni(ue.

)C'))#O$

This study aimed at evaluating the efficacy of pla(ue removal by comparing horizontal scrub,

Fones, and modified Bass techni(ues of brushing in 1st and "nd grade school children in the

age group of # years. Da9ority of the children in this study spontaneously used variations

of the horizontal scrub techni(ue. everal studies have reported the use of the horizontal

scrub techni(ue to be the method of choice in young children because of the inability to apply

other tooth brushing methods.6#,4,7 The authors suggested that horizontal scrub techni(ue is

a suitable way of tooth brushing in preschool children, considering the development of motor

skills at that age.64,7

Tooth brushing skill and the re(uired manual de*terity for tooth brushing are developed in

children aged years and above.6


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and horizontal scrub methods both effectively reduced pla(ue inde* and gingival inde* with

no significant difference between them.

'n our study, horizontal scrub techni(ue was found to be effective in removing pla(ue as

compared to Fones techni(ue. imilarly, Anaise61oll, )harters, and modifiedtillman methods.

'n our study, the pla(ue removal efficacy was found to be least in group ) Fones techni(ue

group0. The probable reason might be ineffective interdental pla(ue removal using Fones

techni(ue. ur results are in accordance with those of Arai et al .6"!7 who observed that

pla(ue removal efficacy was least in Fones techni(ue, but it was found to be the most easily

learnt techni(ue in children. @owever, contrasting results were obtained by Hilkins6+7 who

recommended Fones techni(ue of tooth brushing for school aged children as it is an easily

learnt and effective techni(ue of tooth brushing.

CO$C(')#O$

This study showed that modified Bass techni(ue was the most effective brushing techni(ue

followed by horizontal scrub techni(ue and the least effective was Fones techni(ue. ral

hygiene instruction should be according to a childIs development stage and motor skill.

/ariations in the ability of tooth brushing must be considered, especially with younger

children. 'ntensive individual training of each child is also essential to achieve desired

benefits of the techni(ue.

,ootnotes

)ource of )upport: 5i

Conflict of #nterest: 5one $ecare$.

"E,E"E$CE)

1. 8as JD, Beena K:, Azher J. ral health status of #$ and 1"$year$old school going children

in Bangalore city? An epidemiological study. K 'ndian oc :edod :rev 8ent."!!obinson . A comparative evaluation of the crub and Bass Dethods of toothbrushing

with flossing as an ad9unct in fifth and si*th graders0 Am K :ublic @ealth.1


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. >ugg$%unn AK, Dacgregor '8. A survey of toothbrushing behaviour in children and young

adults. K :eriodontal >es. 1


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:la(ue scores before and after use of Fones techni(ue

,igure /

:la(ue scores before and after use of modified Bass techni(ue

,igure 0


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)omparison of before and after pla(ue scores in horizontal scrub, Fones, and modified Bass

techni(ues

Artice+ rom Journa o Internationa Society o Preventive ? Community

Denti+try are rovi$e$ ,ere courte+y o !ed1no2 3ublications

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