Does the Structure of Dental Hygiene Instruction Impact Plaque Control in Primary School Students?

PURPOSE A 6-month pilot study was conducted to test the assumption that an interactive, contextualized tooth brushing education program would impact the oral hygiene of low income students. METHODS The intervention consisted of an educational program focused on tooth brushing that included interactive sessions with dental professionals and teachers. School 1 students received instruction, toothbrushes, and encouragement to brush their teeth daily after lunch. School 2 students received instruction only. School 3 students only received toothbrushes to remove plaque. Children in all 3 schools were examined by trained dental hygiene students who used plaque disclosing liquid to score the amount of plaque. A predictive correlational design was used to determine the extent that different intervention types and/or demographic/hygiene practices predicted differences in post intervention plaque level, once baseline plaque level was taken into account. RESULTS A total of 254 first and second grade students in 3 public elementary schools in Miami participated in the study. Overall, mean plaque scores were significantly lower at the 6 month follow-up. Between-group comparisons of the mean follow-up scores, adjusted for the effect of the baseline scores, revealed greater but non-significant plaque reduction at School 1 compared to the other schools, and the presence of significant age and ethnic effects. CONCLUSION The most intensive intervention instruction accompanied by repeated practice may lead to improved oral hygiene when compared to instruction alone, when oral hygiene practices and demographic characteristics are taken into account. Design changes intended to increase statistical power may help to explicate these effects.