Supervised toothbrushing programs in primary schools and early childhood settings: A scoping review

Parent-reported toothbrushing behaviour in the Portuguese preschool population

PURPOSE

Study toothbrushing behaviours and associated factors in a Portuguese preschool population.

METHODS

The study population was the parents of children attending Portuguese kindergartens. The data on sociodemographic and toothbrushing behaviours, at home and at school, were collected by an online questionnaire. The data analysis was performed using Chi-square, Fisher, Mann-Whitney and Kruskal-Wallis tests (α = 0.05).

RESULTS

The sample included 711 parents. Most of the children brushed their teeth at home at least twice-a-day (65.3%), with the help of an adult (62.9%). The majority of the children did not brush their teeth at school (71.2%); however, only 9.9% of the parents reported that they don't/wouldn't authorise it. Considering both toothbrushing, at home and at school, 75% of the children brushed their teeth twice-a-day. However, only 7.8% of the children performed all the correct toothbrushing related procedures. Toothbrushing at school was more frequent in private kindergartens (p < 0.001). A higher level of education was associated with non-authorisation of toothbrushing at school (p = 0.019) and with performing the correct toothbrushing related procedures (p = 0.007). Attending an oral health professional appointment was also associated with performing the correct toothbrushing related procedures (p = 0.005).

CONCLUSION

Toothbrushing twice-a-day was frequent in the studied population, however, the percentage of children who brushed at school was low, as well as the percentage of children who performed all the correct toothbrushing related procedures. Toothbrushing at school was more likely in private kindergartens. Performing correct toothbrushing related procedures was more frequent in children who had a previous oral health appointment and whose parents had a higher education level.

Barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools: a systematic review

Background

Untreated dental caries negatively impacts a child's quality of life including overall health and wellbeing, growth and development, social interaction ability, and school attendance. School-based toothbrushing programs have been recognised as an effective intervention to reduce the burden of dental caries. However, limited information is available to understand the real-world enablers and challenges in the implementation and sustainability of toothbrushing programs. This review aims to understand the barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools.

Methods

Five electronic databases [i.e., CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), Web of Science, and PsycINFO] and backward citation chasing were performed. The last updated databases searches were conducted in May 2022. Studies reporting on barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings or primary schools were included in the review. The methodological quality of included studies was assessed by using Joanna Briggs Institute [JBI] and mixed methods appraisal tool [MMAT] critical appraisal tools and results were reported in accordance with PRISMA guidelines.

Results

A total of six studies met the eligibility criteria and were included in the review. Toothbrushing programs in early childhood settings and primary schools were mostly implemented under the supervision of staff and teachers. A positive attitude of the staff, the flexibility of toothbrushing sessions, involvement of community volunteers and parents were a few of the identified enablers. However, the timing of the communication of the program, inadequate transfer of information among staff, frequent staffing turnover, lack of parental support, and staff feeling overburdened while acting as pseudo parents were frequently reported as barriers.

Conclusion

The results of this systematic review identify key enablers and barriers for toothbrushing programs in early childhood settings and primary schools which need to be considered for developing oral health promotion initiatives.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02270-7.

Use of Water by Schoolchildren: Impact of Indirectly Supervised Daily Toothbrushing-A Pilot Study

Aim

This present longitudinal, quantitative, and analytical pilot study evaluated the impact of daily indirectly supervised toothbrushing on water consumption.

Materials and methods

The study was carried out in a social center that provided care to children aged 5–14 years in Campinas in the state of São Paulo. Calibrated hydrometers were installed on taps used by the children, and the daily volume of water used was measured for 25 school days (T0). An educational program was then implemented (T1), where supervised toothbrushing was explained, encouraged, and put into action. The next phase (T2) incorporated a recreational approach to the rational use of water, and the consumption was measured for another 25 school days. After six months (T3) without further educational interventions by the researchers, water consumption was measured for the same period of 25 school days. The data were analyzed based on the mixed models methodology for measures repeated over time.

Results

The water consumption did not change significantly (p > 0.05) between the different phases of the study (T0 = 0.43 ± 0.19, T1 = 0.38 ± 0.17, T2 = 0.39 ± 0.15, T1 = 0.48 ± 0.21 dm³/day/child).

Conclusion

The introduction of toothbrushing into the routine of the children, in the context of recreational and sustainable health education, did not have a detrimental impact on water consumption.

Clinical significance

Among the many recommendations for the introduction and implementation of supervised toothbrushing programs in school environments, there is no mention of the measures taken during such procedures aimed at economizing water, the rational use of which should be a daily practice irrespective of the water conditions of the surrounding region. The findings of this study contribute to the enhancement of educational and pedagogical activities in schools.

How to cite this article

Flório FM, dos Santos Klee L, Brandão Ramos AP, et al. Use of Water by Schoolchildren: Impact of Indirectly Supervised Daily Toothbrushing—A Pilot Study. Int J Clin Pediatr Dent 2020;13(5):513–517.

Prevalence of Dental Caries in 5- and 6-Year-Old Myanmar Children

There are no national data available of the oral health in Myanmar. In this study, we examined dental caries status of 187 school children located in the suburban area of Naypyidaw, capital of Myanmar, at the age of five and six and analyzed by the individual level and tooth level. Maxillary D and B were sensitive for dental caries almost at the same level. They were less sensitive than maxillary A. Mandibular A and B were tolerant for dental caries. Prevalence of dental caries in Myanmar children was still high. By applying item response theory and multilevel modeling, tooth level analysis can be implemented to confirm the tendency for sensitivity or tolerance for dental caries by the tooth level.