Influence of supervised toothbrushing program on brushing skills among children of 6-7Y

Objectives: Daily tooth brushing is one of the most important measures to prevent dental decay. However, many children do not actually follow this recomended practice at home. To overcome this shortcoming, the school based supervised tooth brushing approach was developed. The objective of this study was to evaluate the effectiveness of a pilot supervised tooth brushing program among first and second grade primary school children in Beit Safafa, near Jerusalem.
Methods: 154 children age 6-7 in 5 classes participated. Three classes practiced daily supervised tooth brushing while two classes served as control and recieved oral hygiene instructions, and tooth brushes and pastes for home use. The brushing skills were assessed by the "Brushing Skills Index" before and after the program. Differences in accessed areas in the mouth were compared between the two study groups.
Results: Before the program, only 25% brushed more than Three areas of the teeth. After the program, this fraction increased to 51%. The most notable improvement was for occlusal surfaces - at the final examination only 15% didn't brush those areas vs. 49% at the beginning of program. The change in the supervised tooth brushing group was significantly higher than that of the control group, suggesting a positive effect of this intervention.
Conclusions: The study showed that supervised tooth brushing programs are feasible, practical and beneficial even in primary schools settings. However many practical issues remain; the actual adherence to the daily practice was not always optimal, and very dependent on the teachers' motivation. Optimal running of such programs should involve higher educational authorities, to help in implementing and monitoring.