Small Group Instruction and Application-aided Brushing Time in Children

Objectives: A parallel group trial evaluated small group instruction with a computer application on children’s brushing time.
Methods: Prior to study initiation, institutional review was obtained and target elementary schools (Guatemala City, Guatemala) were identified, kindergarten and first grade classes were selected, and school administration support was obtained. After parental consent, volunteer children age 5-7 were assigned to small groups (n~5) for either application-aided brushing (APP) or normal oral hygiene (CON), the latter of which served as the experimental control. Subjects in each of the small groups were dispensed products for open-label at-school, including a children’s regular manual brush (Oral-B® Stages Etapa 3) and a 75 mL tube of 0.243% sodium fluoride paste (Oral-B Stages Pasta Dental). Children assigned to APP performed small group oral hygiene with a computer-projected brushing application featuring popular movie characters (Disney Magic Timer™ by Oral-B), while CON groups performed regular hygiene. No instructions other than the adjunct use of the brushing application were provided. Brushing times were measured (in sec) for each child, and instructional groups were compared with a two-sided 5% level of significance.
Results: A total of 145 subjects were enrolled, 70 assigned to APP, and 75 to CON. Of these, 50 were age 5, 49 age 6, and 46 age 7, with girls representing 54% of the population. There was a statistically significant (p<0.0001) mean difference in brushing time (in sec) between APP and CON, with means (SE) of 116.3 (1.0) for APP versus 77.7 (3.8) for CON. Brushing time was 50% greater with application use, and significant (p<0.01) effects were evident within each age and gender strata.
Conclusions: This research demonstrates merit of a character-based brushing time application for group hygiene instruction in educational settings, where first-time use yielded a 50% increase in brushing time versus normal hygiene.