Journal of Indian Society of Pedodontics and Preventive Dentistry
Journal of Indian Society of Pedodontics and Preventive Dentistry
                                                   Official journal of the Indian Society of Pedodontics and Preventive Dentistry                           
Year : 2018  |  Volume : 36  |  Issue : 1  |  Page : 82--85

Impact of oral health education by audio aids, braille and tactile models on the oral health status of visually impaired children of Bhopal City


Anjali Gautam1, Ajay Bhambal1, Swapnil Moghe2,  
1 Department of Public Health Dentistry, People's College of Dental Science and Research Centre, Bhopal, Madhya Pradesh, India
2 Department of Oral and Maxillofacial Surgery, People's College of Dental Science and Research Centre, Bhopal, Madhya Pradesh, India

Correspondence Address:
Dr. Anjali Gautam
C-2/114, Janakpuri, New Delhi - 110 058
India

Abstract

Context: Children with special needs face unique challenges in day-to-day practice. They are dependent on their close ones for everything. To improve oral hygiene in such visually impaired children, undue training and education are required. Braille is an important language for reading and writing for the visually impaired. It helps them understand and visualize the world via touch. Audio aids are being used to impart health education to the visually impaired. Tactile models help them perceive things which they cannot visualize and hence are an important learning tool. Aim: This study aimed to assess the improvement in oral hygiene by audio aids and Braille and tactile models in visually impaired children aged 6–16 years of Bhopal city. Settings and Design: This was a prospective study. Materials and Methods: Sixty visually impaired children aged 6–16 years were selected and randomly divided into three groups (20 children each). Group A: audio aids + Braille, Group B: audio aids + tactile models, and Group C: audio aids + Braille + tactile models. Instructions were given for maintaining good oral hygiene and brushing techniques were explained to all children. After 3 months' time, the oral hygiene status was recorded and compared using plaque and gingival index. Statistical Analysis Used: ANNOVA test was used. Results: The present study showed a decrease in the mean plaque and gingival scores at all time intervals in individual group as compared to that of the baseline that was statistically significant. Conclusions: The study depicts that the combination of audio aids, Braille and tactile models is an effective way to provide oral health education and improve oral health status of visually impaired children.



How to cite this article:
Gautam A, Bhambal A, Moghe S. Impact of oral health education by audio aids, braille and tactile models on the oral health status of visually impaired children of Bhopal City.J Indian Soc Pedod Prev Dent 2018;36:82-85


How to cite this URL:
Gautam A, Bhambal A, Moghe S. Impact of oral health education by audio aids, braille and tactile models on the oral health status of visually impaired children of Bhopal City. J Indian Soc Pedod Prev Dent [serial online] 2018 [cited 2021 Mar 1 ];36:82-85
Available from: https://www.jisppd.com/text.asp?2018/36/1/82/228746


Full Text



 Introduction



Health Education Is a Process of Transmission of Knowledge and Skills, Which in Turn Improves the Quality of Life. Schools Are Thought to Be the Most Suitable Medium to Provide Health Education to the Children. for Children With Sensory Disabilities, Many Teaching Methods and Mechanical Aids Are Available to Enhance Their Development.

Visual impairment is a rising challenge in developing countries. They face limitations in understanding as they have to rely on their tactile sensations.[1] Blindness is defined by the WHO as having a “visual acuity of <3/60 m or corresponding visual field loss in the better eye with the best possible correction,” meaning that, while a visually impaired person could see till 3 m, a normal-sighted person could see clearly till 60 m. They have deprived oral hygiene and are dependent on health-care workers for most of the routine work. India is expected to have >15 million visually impaired personnel.

 Materials and Methods



Sixty visually impaired children aged 6–16 years were selected and randomly divided into three groups (20 children each). Group A: audio aids + Braille, Group B: audio aids + tactile models, and Group C: audio aids + Braille + tactile models. Instructions were given for maintaining good oral hygiene and brushing techniques were explained to all children. After 3 months' time, the oral hygiene status was recorded and compared using Plaque and Gingival index.

Children with a recent dental treatment, having a history of systemic antibiotics or topical fluoride treatments, using xylitol chewing gums, and having severe medical conditions were excluded from the study.

Ethical clearance was obtained from the Institutional Ethical Committee of People's College of Dental Science and Research, Bhopal, Madhya Pradesh. Permission was taken from two residential institutions for visually challenged children in Bhopal city after explaining the benefits of the study. The parents were informed and consent was taken.

The instructions on how to brush and floss were given through Braille and tactile models and audio aids. The children were given balanced diet meal throughout the study period, and snacks in between meals were restricted. The resident school in-charge was instructed to keep track to make sure that all the children follow the instructions properly.

Sixty visually impaired children with no systemic diseases and those not using probiotic or oral hygiene supplements were included in this study. Their oral hygiene was assessed using the Plaque and gingival index.[2] The scores were recorded at baseline data.

After 1 month, the plaque and gingival index [2] was taken to check the efficacy of children maintaining their oral hygiene and data were recorded. The children were instructed to continue the practice for 3 more months and then again the plaque and gingival index was checked.

The data thus obtained were subjected to statistical analysis using ANOVA test. The results were tabulated and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp).

 Results



The collected data were analyzed using ANOVA to analyze the intra- and intergroup comparisons. On intragroup comparison, mean plaque scores showed a gradual decline from baseline to 3 months in all the groups.

A greater reduction in mean plaque scores was observed at 3 months' interval when compared to those at baseline and 1 month interval [Table 1]. Similarly, the mean gingival scores declined from baseline to 3 months in all the groups. A greater reduction in mean gingival scores was observed at 3 months' interval when compared to those at baseline and 1 month interval [Table 2].{Table 1}{Table 2}

Reduction in plaque scores was observed at 3 months' interval when compared to baseline and 1 month with all the groups. Group C (combination of audio aids + Braille + tactile models) showed higher percentage of reduction at 3 months' interval when compared to that of Groups A and B [Table 3] and [Graph 1].{Table 3}[INLINE:1]

Greater percentage of reduction in gingival scores was observed at 3 months' interval, when compared to those at baseline and 1 month with all the groups [Table 2] and [Table 4], [Graph 2].{Table 4}[INLINE:2]

 Discussion



Visual impairment can have a deleterious effect on oral hygiene. Motivating children with visual impairment is a challenging job for dental surgeons, as techniques to show biofilm formation cannot be used here. Some persons have compromised oral hygiene than their sighted peers.[1],[3] They have increased tendency for calculus and debris deposition than normal peers. Several studies have hinted upon the usage of verbal instructions and tactile aids to maintain oral hygiene and improve brushing.[4],[5],[6]

Nogueira Filho et al.[7] depicted that dental biofilm control should be stressed upon for caries prevention and gingival inflammation, as dental biofilm is the main agent for the development of caries and periodontal disease.

Faustino-Silva et al.[8] contradicted that dental biofilm control is important for the prevention of caries and gingivitis in children and stressed the need of oral health education and promotion in preventing early tooth loss.

O'Donnell and Crosswaite [6] found that visually impaired children were very adaptive at converting oral instructions into manual oral hygiene practices. This confirms that adequately given verbal instruction can improve oral health status in visually impaired individuals. Dental plaque is the main culprit for the development of periodontal diseases and dental caries.[9]

Education is the important milestone for behavioral changes in children. Oral health education creates healthier atmosphere to enhance oral health-care practices among schoolgoing children. School is the best medium to learn and apply preventive dental health practices.[10],[11]

Different studies have advocated the use of various media to correlate the association of risk factors for dental caries and oral hygiene. The instructions given to the children associated with certain kinds of disability should be clear and easy to understand.

Hence, in the present study, instructions with the use of tactile models, audio aids, and oral hygiene instructions in Braille were utilized to promote motivation in children.

Even though all the three groups showed decrease in plaque score, intergroup comparison of plaque index score was statistically nonsignificant. In a study conducted by Mendonca,[12] it was stated that the absence of visual stimuli prevents rapid learning, representing a challenge for surgeons and dentists in motivating these individuals to have appropriate oral hygiene. However, it is arguable that, when well trained, visually impaired children can learn the brushing techniques, thus maintaining good oral condition.

The present study showed a decrease in the mean plaque scores at all time intervals in individual group as compared to the baseline that was statistically significant. This shows that a proper method of educating the visually impaired children will decrease the plaque score that in turn will improve the oral hygiene.

 Conclusions



The study depicts that the combination of audio aids and Braille and tactile models is an effective way to provide oral health education and improve oral health status of visually impaired children.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Anaise JZ. Periodontal disease and oral hygiene in a group of blind and sighted Israeli teenagers (14-17 years of age. Community Dent Oral Epidemiol 1979;7:353-6.
2Podshadley AG, Haley JV. A method for evaluating oral hygiene performance. Public Health Rep 1968;83:259-64.
3Greeley CB, Goldstein PA, Forrester DJ. Oral manifestations in a group of blind students. ASDC J Dent Child 1976;43:39-41.
4Winstanley ML. A synopsis of the project to evaluate the use of a braille text and tactile aids when teaching dental health to blind children. Br Dent Surg Assist 1983;42:20-3.
5Cohen S, Sarnat H, Shalgi G. The role of instruction and a brushing device on the oral hygiene of blind children. Clin Prev Dent 1991;13:8-12.
6O'Donnell D, Crosswaite MA. Dental health education for the visually impaired child. J R Soc Health 1990;110:60-1.
7Nogueira Filho GR, Toledo S, Cury JA. Evaluation of the effect of dentifrice containing triclosan - gantrez - zinc - pyrophosphate on experimental gingivitis in humans. Periodontia 1997;6:20-4.
8Faustino-Silva DD, Ritter F, Nascimento IM, Fontanive PV, Persici S, Rossoni E. Oral health care in preschool children: Perceptions and knowledge of parents or legally responsible persons in a health care center of Porto Alegre, RS. Rev Odonto Cienc 2008;23:375-9.
9Yalcinkaya SE, Atalay T. Improvement of oral health knowledge in a group of visually impaired students. Oral Health Prev Dent 2006;4:243-53.
10Christensen GJ. Special oral hygiene and preventive care for special needs. J Am Dent Assoc 2005;136:1141-3.
11Flanders RA. Effectiveness of dental health educational programs in schools. J Am Dent Assoc 1987;114:239-42.
12Mendonca A, Miguel C, Neves G, Micaelo M, Reino V. Curricular guidelines. Brasilia: Ministry of Education; 2008.