Year : 2009 | Volume
: 27 | Issue : 2 | Page : 104--107
Tooth brushing skills for the children aged 3-11 years
UM Das, P Singhal
Department of Pedodontics and Preventive Dentistry, V. S. Dental College and Hospital, K. R. Road, V.V. Puram, Bangalore - 560 004, Karnataka, Department of Paedodontics & Preventive Dentistry, HP Govt. Dental College, Shimla, India
U M Das
Department of Pedodontics and Preventive Dentistry, K.R. Road, V.V. Puram, Bangalore-560 004, Karnataka
Objectives: The objective of this study was to evaluate tooth brushing management and ability of children in relation to age and gender. Materials and Methods: The study population consisted of 45 children, who attended Department of Pedodontics and Preventive Dentistry at V.S Dental College and Hospital Bangalore. Children were divided into three groups according to age: Group I: 3-5 years, Group II: 6-8 years, and Group III: 9-11 years. Each child selected his/her favorite toothbrush and brushed his/her teeth under supervision of one instructor. The grip type during tooth brushing was recorded on a videotape and duration of tooth brushing also was noted. The data were analyzed in relation to the age and gender using the chi-square test. ANOVA was used to find if there is any significant difference between the mean brushing times in the different groups. Results: The results of statistical analysis showed that in all cases P >0.05 for grip preferences and P <0.001 between age groups 3-5 years and 9-11 years with respect to the mean brushing time. Conclusion: The required manual dexterity for tooth brushing was present in younger age groups.
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Das U M, Singhal P. Tooth brushing skills for the children aged 3-11 years.J Indian Soc Pedod Prev Dent 2009;27:104-107
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Das U M, Singhal P. Tooth brushing skills for the children aged 3-11 years. J Indian Soc Pedod Prev Dent [serial online] 2009 [cited 2020 Apr 5 ];27:104-107
Available from: http://www.jisppd.com/text.asp?2009/27/2/104/55335
Tooth brushing and other mechanical measures are the most practical and effective means of achieving and maintaining adequate oral hygiene. ,, Although tooth brushing is a simple and effective means of removing plaque, the high prevalence of periodontal disease in the general population indicates that tooth-brushing performance is inadequate. ,,,,,,, Up to now, the toothbrush still remains the most efficient of all cleaning devices. Brush design and mechanization of the brushing process have been the subject of innumerable studies. Various designs of toothbrushes have been recommended to enhance the mechanical removal of dental plaque.  A number of studies have been conducted examining tooth-brushing time, but there are few studies about how people grip a toothbrush during a normal brushing session.  Effective tooth brushing depends on technically correct tooth brush and on patient compliance. Tooth brushing remains the most efficient long-term means of removing the dental plaque in children. Children's capacity to use the toothbrush varies greatly not only according to their age but also to their individual dexterity and motivation.  The aim of the study was to evaluate the tooth-brushing management and ability of children in relation to age and gender.
Materials and Methods
The study sample consisted of 45 children, who attended Depatment of Pedodontics and Preventive Dentistry at V.S Dental College and Hospital, Bangalore. Children were divided into three groups according to age:
Group I: 3-5 years
Group II: 6-8 years
Group III: 9-11 years
Two types of child toothbrushes were chosen [Figure 1]. Each child selected his/her favorite tooth brush and brushed his/her teeth under supervision of one instructor. The grip type during tooth brushing was recorded on a videotape and duration of tooth brushing was also noted. Manual dexterity of children was evaluated according to Beals et al.  [[Figure 2]: Precision, Oblique, Distal Oblique and Spoon Grips].
The data were analyzed in relation to the age and gender using the chi-square test. ANOVA test was used to find if there is any significant difference between the mean brushing times in the different groups.
Out of 45 children who participated in the study, 24 were males (47%) and 21 were females (53%). A 43% of children brushed their teeth with more than one type of grip. Most preferred grip type was distal (64 %), followed by power (42%) and oblique grips (33%). Two boys and one girl had uncharacteristic grip. Spoon grip was uncommon (2.2%) [Table 1] and [Figure 3]. There was no statistically significant difference between age groups and the grip types ( P >0.05). No significant difference was found between boys and girls in grip preferences ( P >0.05).
The mean brushing time for 3- to 5-year age group found was of 45 seconds, and 48 and 87 seconds, respectively, for 6- to 8 and 9- to 11 years age groups. Total mean brushing time was of 60.29 seconds [Table 2] and [Figure 4]. Significant difference between age groups 3-5 years and 9-11 years with respect to the mean brushing time ( P P =0.909).
In this study, manual dexterity and the grip type during brushing were evaluated. Some investigators emphasized advisability of parental brushing of teeth for young child. McClure  stated that 3-year-old children were unable to wield the toothbrush, and parents brushed the children's teeth more efficiently after instruction. Macgregor and RuggGunn  found that the mean duration of brushing was of 60.3 seconds in 85 uninstructed schoolchildren. In our study, we found that duration of brushing was short in all age groups. The same investigators  stated that the mean duration of brushing was of 33 seconds in 60 uninstructed adults.
Various observations have been made on tooth-brushing time and motion, but little has been published about grip type. This aspect is important in the development of toothbrushes. Beals et al .  investigated grip type in 71 adults. He stated that distal oblique grip was used more than twice as frequently as any other grip. The spoon grip was relatively uncommon. In our study the most preferred grip type was distal (64 %) followed by power (42%) and oblique grips (33%). Two boys and one girl had uncharacteristic grip. Spoon grip was uncommon (2.2%). There was no statistically significant difference between age groups and the grip types ( P >0.05). No significant difference was found between boys and girls in grip preferences ( P >0.05). Beals et al .  stated that brushing grips did not vary significantly across males and females. Our findings agree with those of Ali M and Julide A12, in their study they found children between 3 and 11 years preferred distal type of grip followed by power and oblique. The present study has following limitations: small sample size, the subjects of the present study were aware that their brushing was observed, filming with the subject's knowledge might be expected to improve tooth brushing. The effect of awareness of filming needs further investigation.
In conclusion, the present study affirms the need for tooth-brushing instructions in young children according to their manual skills. The required manual dexterity for tooth brushing was present in younger age groups. Instructions should be given according to the child's degree of readiness for tooth brushing and their status of psychological development and should include systematic training and reinforcement. Intensive individual training is essential.
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