Oral Hygiene Indirect Instruction and Periodic Reinforcements: Effects on Index Plaque in Schoolchildren

The aim of this study was to evaluate the effectiveness of the indirect instruction and the influence of the periodic reinforcement on the plaque index in schoolchildren. Forty schoolchildren aged from 7 to 9 years old were selected from a public school. After determining the initial O'Leary Plaque Index all schoolchildren were submitted to a program for oral hygiene through indirect instruction –"The Smiling Robot". The schoolchildren were divided into 2 groups: with and without motivation reinforcement. The index plaque exam was performed in both groups after 30, 60 and 90 days of the educational program. Comparing the groups, the plaque index decreasing could be observed in the group with reinforcement with statistically significant difference. For the group with reinforcement, statistically significant difference among the evaluations was found. For the group without reinforcement, significant decrease in the plaque index was found after 30 days when compared to the first, third and fourth evaluations. The indirect instruction with "The Smiling Robot" promoted a positive initial impact on the decrease of plaque index in the schoolchildren. The periodic reinforcements showed more suitable results and significant reduction of the plaque index in the course of the evaluations.

School based preventive programs, Motivation, Dental plaque, Oral hygiene

1. Axelson P, Lindhe J. Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. J Clin Periodontol, 5: 133–151, 1978.

2. Leal SC, Bezerra ACB, Toledo OA. Effectiveness of teaching methods for toothbrushing in preschool children. Braz Dent J, 13: 133–136, 2002.

3. Axelsson P, Paulander J, Syardstrom G, Tollskog G, Nordensten S. Integrated caries prevention: effect of a needs-related preventive pro-gram on dental caries in children. County of Varmland, Sweden. Caries Res, 27: 83–94, 1993.

4. Garcia-Godoy F. La salud buccal como parte del processo de socializacion. Acta Odontol Pediat, 7: 11–3, 1986.

5. Tsamtsouris A, White GE, Clark ER. The effect of instruction and supervised toothbrushing on the reduction of dental plaque in kinder-garten children. J Dent Children, 46: 204–209, 1979.

6. Gjermo P. Audio-visual motivation and oral hygiene instruction. The effect upon gingival status and oral cleanliness in 15 years old children. Odontol Revy, 23: 253–262, 1972.

7. Ivanovic M, Lekic P. Transient effect of a short-term educational pro-gram without prophylaxis on control of plaque and gingival inflamma-tion in school children. J Clin Periodontol, 23: 750–757, 1996.

8. Axelsson P, Buischi YA, Barbosa MF, Karlsson R, Prado MC. The effect of a new oral hygiene training program on proximal caries in 12- 15- year-old Brazilian children: Results after three years. Adv Dent Res, 8: 278–284, 1994.

9. Rodrigues JA, Santos PA, Garcia PPNS, Corona SAM, Loffredo LCM. Evaluation of motivation methods to obtain appropriate schoolchild-ren’s oral hygiene levels. Int J Dent Hyg, 1: 227–232, 2003.

10. O’Leary TJ, Drake, RB, Naylon JE. The plaque control record. J Peri-odontol, 73: 38–42, 1972.

11. Peng B, Petersen PE, Fan MW, Tai BJ. Oral health status and oral health behaviour of 12-year-old urban schoolchildren in the People’s Republic of China. Comm Dent Health Deas,14: 238–244, 1997.

12. Vignarajah S. Oral health knowledge and behaviours and barriers to dental attendance of school children and adolescents in the Caribbean island of Antigua. Int Dent J, 47: 167–172, 1997.

13. Östberg A, Halling A, Lindbald U. Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents. Acta Odontol Scand, 57: 231–236, 1999.

14. Christensen GJ. Special oral hygiene and preventive care for special needs. J Am Dent Assoc, 136: 1141–1143, 2005.

15. Hollister MC, Anema MG. Health behavior models and oral health: a review. J Dent Hyg, 78: 6, 2004.

16. Okada M, Kuwahara S, Kaihara Y, Ishidori H, Kawamura M, Miura K, Negasaka M. Relationship between gingival health and dental caries in children aged 7-12 years. J Oral Sci, 42: 151–155, 2000.

17. Daly CG, Chapple CC, Cameron AC. Effect of toothbrush wear on plaque control. J Clin Periodontol, 23: 45–49, 1996.

18. Guldener PH, Adlivankine WA. How do I motivate my patients toward good and permanent oral hygiene? Int Dent Dig, 4: 31–32, 1973.

19. Horowitz AM. Effective oral health education and promotion programs to prevent dental caries. Int Dent J, 33: 171–181, 1983.

20. Buischi YA, Axelsson P, Oliveira, LB, Mayer MP, Gjermo P. Effect of two preventive programs on oral health knowledge and habits among Brazilian schoolchildren. Comm Dent Oral Epidemiol, 22: 41–46, 1994.