Evaluation of toothbrushing education by hygienists for schoolchildren

Introduction: Dental health education is an integral component of public health promotion. The Israeli Ministry of Health encourages and supports health education sessions delivered by dental hygienists among elementary schoolchildren. The objectives of the present study focused on evaluation of an innovative simple approach of teaching tooth brushing skills and other essential subjects related to oral health. Methods: The study population consisted of 196 children from nine first grade classes in two Jerusalem neighborhoods. The examiner initially interviewed the children and recorded base-line brushing skills. This was followed by three lessons by the hygienist. After this a final evaluation was conducted by the examiner. A simple horizontal scrub brushing method was taught with emphasis on reaching all teeth and all surfaces. Results: At base-line most commonly children brushed their labial surfaces of anterior maxillary and mandibular teeth (92%) and least of all lingual surfaces of posterior maxillary and mandibular teeth (0.1%). Furthermore those who previously had not brushed, the largest improvement (statistically significant at p<0.001) was also for labial surfaces of anterior maxillary and mandibular teeth (90%) and the least improvement (statistically significant at p<0.001) for lingual surfaces of posterior maxillary and mandibular teeth (39%). The average number of tooth surfaces increased from 2.8 till 5.7 (statistically significant at p<0.001). Conclusion: This simple method of evaluation and instruction emphasized those areas of the dentition which demand the most efforts in dental health education. Further areas which indicate promotion have also been identified. These data are helpful in improving and planning future health education programs of dental hygienists in Israel.