Impact of visual instruction on oral hygiene status of children with hearing impairment

Visual learning strategies for oral health promotion and treatment interventions in children and adolescents with hearing impairment - A systematic review

AIM

People with hearing impairment (HI) prefer visual learning strategies in daily activities owing to their reliance on vision. The aim of this systematic review is to evaluate the effectiveness of visual learning as a communication strategy in improving oral hygiene and dental care of children and adolescents with HI.

METHODS AND RESULTS

Four electronic databases were searched and complemented by hand searching for original intervention studies published till December 2021. Eligible studies were screened, data was extracted as per priori data collection form and analyzed by thematic content analysis. The quality of studies was assessed as per the validated tools appropriate for study designs including ROB2, ROBINS-I, and NIH quality assessment tool. Out of 4159 records identified and 1302 duplicates removed, 24 original studies were identified and the visual learning strategies were classified into sign language, visual aids with or without sign language, customized educational demonstrations and the interim role of training the teachers. These strategies helped in improving oral hygiene status, oral health-related knowledge and attitude as well as dental anxiety during treatment. Participants were found to be satisfied with these strategies, however, significant heterogeneity in the included studies precluded meaningful meta-analysis. ROB2 and ROBINS were rated as high and serious in all included trials, respectively, and NIH Quality Assessment Tool for Pre-Post Studies With No Control as fair in five studies and poor in three.

CONCLUSION

Our findings emphasize the significance of visual learning, however, long-term rigorously designed trials are needed to better understand effective and patient-centered communication methods for people with HI.

Comparison of Effectiveness of Visual and Sign Motivation on the Oral Hygiene of Students

Aim

The aim of the study is to compare the effectiveness of visual and sign motivation on the oral hygiene of students with hearing and speech impairment studying in special schools of Meerut, Uttar Pradesh, India.

Materials and methods

A cross-sectional study was carried out on 200 students. The sample was divided into two groups. Ethical clearance was obtained from the Institutional Ethical Committee. Data were collected at three points of time-at baseline, 1st and 3rd month.

Results

In the age-group, 8-13 years, on intergroup comparison of mean oral hygiene index (OHI) score, no significant difference was observed on the first visit (p-value of 0.351) and second visit, respectively (p-value of 0.687), but on comparing the mean simplified oral hygiene index (OHI-S) score on third visit significant difference was observed (p-value of 0.03) and in the age 14-18 years, on intergroup comparison of mean OHI-S score no significant difference was observed on first visit (p-value of 0.593) and second visit, respectively (p-value of 0.404), but on comparing the mean OHI-S score on third visit, significant difference was observed (p-value of 0.018) Both the groups have shown that there was the positive impact of reinforcement on the oral hygiene of students in this age-group as well.

Conclusion

There was a significant improvement in oral hygiene status and a significant improvement in participant satisfaction toward oral health in both groups. Sign language video playback is not as effective and efficient in improving the maintenance of oral health in hearing and speech-impaired children as compared to sign language.

Clinical significance

This study has helped in the better understanding of different methods of maintaining good oral hygiene of hearing and speech-impaired children.

How to cite this article

Singh R, Saraf BG, Sheoran N, et al. Comparison of Effectiveness of Visual and Sign Motivation on the Oral Hygiene of Students. Int J Clin Pediatr Dent 2023;16(5):671-677.

Impact of the Visual Performance Reinforcement Technique on Oral Hygiene Knowledge and Practices, Gingival Health, and Plaque Control in Hearing- and Speech-Impaired Adolescents: A Randomized Controlled Trial

This study aimed to evaluate the impact of oral health education (OHE), incorporating a novel pre-validated visual performance reinforcement (VPR) technique and sign language, on gingival health, plaque control, and oral hygiene knowledge and practices in 12 to 15-year-old hearing- and speech-impaired adolescents. A double-blinded randomized controlled trial was conducted in a government school for deaf children in Belagavi, Karnataka, India. A total of 80 adolescents, aged 12-15 years, were randomly assigned, using a computer-generated table of random numbers, into two groups: Group A receiving the VPR technique (n = 40), and Group B receiving sign language (n = 40). A specially designed pre-validated closed-ended questionnaire was administered to both groups, followed by clinical examination to obtain the gingival and plaque index, before intervention and at a 16-week follow-up period. Group A showed a significant increase in the knowledge gained when compared to Group B. Similarly, a significant improvement in oral hygiene practices was also observed in Group A. However, at the 16-week follow-up, there were no statistically significant differences in gingival and plaque scores between the groups. OHE using the VPR technique can be as effective and satisfactory as sign language in the reduction of gingival and plaque scores and in the improvement of knowledge and its application in oral hygiene maintenance among hearing- and speech-impaired adolescents.

Effectiveness of Visual Distraction with and without Virtual Reality Glasses in Reducing Dental Anxiety among Children with Hearing and Speech Disability: A Pilot Study

Aim and objective

Materials and methods

Results

Conclusion

How to cite this article

Impact of Oral Health Educational Interventions on Oral Hygiene Status of Children with Hearing Loss: A Randomized Controlled Trial

Introduction

Oral health is considered as one of the essential components of the overall health of every individual. Maintaining oral health is a gradual process that requires commitment. Children who require special care such as hearing impairment experience difficulty in maintaining oral health primarily due to communication difficulties. This study is aimed at using different interventions to evaluate the improvement of oral hygiene in hearing impaired children.

Materials and Methods

Fifty-nine children were recruited in this study that were allocated randomly into each group with twenty children as follows: group 1: pictorial, group 2: video, and group 3: control. Mean plaque and gingival scores were noted before and after the use of different interventions. Oral hygiene was categorized as “excellent,” “good,” and “fair.” Gingival health was categorized as “healthy,” “mild gingivitis,” and “moderate gingivitis.”

Results

Thirty-four children (57.6%) were from 12-13 years of age bracket, and 25 (42.4%) belonged to 14-16 years of age. Regarding gender, there were 37 (62.7%) males and 22 (37.3%) females. About comparison of mean gingival and plaque scores before and after interventions in each group, a significant difference was found in group 1 (p < 0.001) and group 2 (p < 0.001), as compared to group 3 where the difference in scores was not significant (p > 0.05).

Conclusion

Maintaining oral health requires the compliance of individuals to perform different methods of preventive dentistry, such as tooth brushing and use of dental floss. The use of different oral hygiene educational interventions such as pictorial and video methods have been proven and useful for hearing impaired children in improving oral health.

Comparison of Plaque Removal Efficacy with Powered and Manual Toothbrushes in 10-14-year-old Visually and Auditory Impaired Children: A Randomized Controlled Study

Aim and objective

To compare dental plaque removal efficacy with a manual and powered toothbrush in 10–14 years old visually and auditory impaired children.

Material and methods

The proposed study was a randomized controlled study. The ethical approval was obtained from the institutional ethical board. The written informed consent for the study was taken from the parents. The 60 participants were categorized into group I: visually impaired (30) and group II: speech and hearing impaired (30) which were again divided into I1 (manual toothbrush) and I2 (powered toothbrush); II1 (manual toothbrush) and II2 (powered toothbrush), respectively. The baseline score was recorded using Turesky–Gilmor–Glickman Modification of The Quigley–Hein plaque Index. The oral prophylaxis was performed and then randomization of the toothbrush group was done with concealed allocation method. The plaque-removal efficacy was evaluated at the end of the 15 days in the visually and hearing-impaired children.

Results

The mean score of dental plaque at baseline was 1.44 for the manual toothbrush group and 1.65 for the powered toothbrush group in visually impaired children, respectively. In blind children with a manual toothbrush, the mean score difference was 0.14 while the powered toothbrush showed the mean score difference of 0.30 which is significant. The mean score of dental plaque at baseline was 1.74 for the manual toothbrush group and 1.80 for the powered toothbrush group in auditory impaired children. In auditory impaired children with manual toothbrushes, the mean score difference was 0.15 while the powered toothbrush showed the mean score of 0.32 which was significant.

Conclusion

Dental plaque reduction was significantly better with the powered toothbrush as compared to a manual toothbrush in visually and auditory impaired children.

How to cite this article

Patel NG, Bargale S, Shah S, et al. Comparison of Plaque Removal Efficacy with Powered and Manual Toothbrushes in 10–14-year-old Visually and Auditory Impaired Children: A Randomized Controlled Study. Int J Clin Pediatr Dent 2021;14(3):364–368.

Impact of educational (sign language/video modeling) and therapeutic (Glycyrrhiza glabra--liquorice mouth wash) interventions on oral health pertaining to children with hearing impairment: A randomized clinical trial

PURPOSE

To compare the effect of educational (sign language and video modeling) and therapeutic intervention (liquorice) on oral hygiene status of children with hearing impairment (CHI).

METHODS

Ninety-three CHI, in the age range of 5-15 years, were recruited in to the study. Children were assigned to two educational intervention groups: sign language and video modeling. Each group was again randomly divided into two: with one subgroup receiving therapeutic intervention using liquorice as a mouth wash and the other group receiving no intervention. For all children, baseline oral hygiene, gingival, and plaque index scores were recorded and oral prophylaxis was performed. Based on the subgroup to which the child was assigned, oral hygiene instructions were given on a weekly basis, whereas therapeutic intervention was performed twice daily for 28 days. Reassessment was done after the completion of interventions and after 3 months, followed by statistical analysis.

RESULTS

There was a significant mean reduction in oral hygiene, gingival, and plaque scores in all the children. The educational intervention could not influence the scores recorded, but the therapeutic intervention with liquorice led to a reduction in all the oral health parameters during the follow-up periods.

CONCLUSION

Therapeutic intervention using liquorice as mouth wash along with educational intervention can be suggested in CHI.

One-to-one oral hygiene advice provided in a dental setting for oral health

BACKGROUND

Effective oral hygiene measures carried out on a regular basis are vital to maintain good oral health. One-to-one oral hygiene advice (OHA) within the dental setting is often provided as a means to motivate individuals and to help achieve improved levels of oral health. However, it is unclear if one-to-one OHA in a dental setting is effective in improving oral health and what method(s) might be most effective and efficient.

OBJECTIVES

To assess the effects of one-to-one OHA, provided by a member of the dental team within the dental setting, on patients' oral health, hygiene, behaviour, and attitudes compared to no advice or advice in a different format.

SEARCH METHODS

Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 November 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 10) in the Cochrane Library (searched 10 November 2017); MEDLINE Ovid (1946 to 10 November 2017); and Embase Ovid (1980 to 10 November 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials (10 November 2017). No restrictions were placed on the language or date of publication when searching the electronic databases. Reference lists of relevant articles and previously published systematic reviews were handsearched. The authors of eligible trials were contacted, where feasible, to identify any unpublished work.

SELECTION CRITERIA

We included randomised controlled trials assessing the effects of one-to-one OHA delivered by a dental care professional in a dental care setting with a minimum of 8 weeks follow-up. We included healthy participants or participants who had a well-defined medical condition.

DATA COLLECTION AND ANALYSIS

At least two review authors carried out selection of studies, data extraction and risk of bias independently and in duplicate. Consensus was achieved by discussion, or involvement of a third review author if required.

MAIN RESULTS

Nineteen studies met the criteria for inclusion in the review with data available for a total of 4232 participants. The included studies reported a wide variety of interventions, study populations, clinical outcomes and outcome measures. There was substantial clinical heterogeneity amongst the studies and it was not deemed appropriate to pool data in a meta-analysis. We summarised data by categorising similar interventions into comparison groups.Comparison 1: Any form of one-to-one OHA versus no OHAFour studies compared any form of one-to-one OHA versus no OHA.Two studies reported the outcome of gingivitis. Although one small study had contradictory results at 3 months and 6 months, the other study showed very low-quality evidence of a benefit for OHA at all time points (very low-quality evidence).The same two studies reported the outcome of plaque. There was low-quality evidence that these interventions showed a benefit for OHA in plaque reduction at all time points.Two studies reported the outcome of dental caries at 6 months and 12 months respectively. There was very low-quality evidence of a benefit for OHA at 12 months.Comparison 2: Personalised one-to-one OHA versus routine one-to-one OHAFour studies compared personalised OHA versus routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality).Comparison 3: Self-management versus professional OHAFive trials compared some form of self-management with some form of professional OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis or plaque (very low quality). None of the studies measured dental caries.Comparison 4: Enhanced one-to-one OHA versus one-to-one OHASeven trials compared some form of enhanced OHA with some form of routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality).

AUTHORS' CONCLUSIONS

There was insufficient high-quality evidence to recommend any specific one-to-one OHA method as being effective in improving oral health or being more effective than any other method. Further high-quality randomised controlled trials are required to determine the most effective, efficient method of one-to-one OHA for oral health maintenance and improvement. The design of such trials should be cognisant of the limitations of the available evidence presented in this Cochrane Review.

Incidence of oral health in paediatric patients with disabilities: Sensory disorders and autism spectrum disorder. Systematic review II

Introduction

We are currently witnessing an increase in the number of disabled patients, creating the need for knowledge of each of the pathologies and of the different oral and dental conditions they present, in order to achieve efficient management and treatment.

Objectives

To analyse the existing scientific literature on the oral conditions of children with autism spectrum disorder (ASD) and children with sensory deficits (SD), in comparison with the healthy child population.

Material and Methods

The bibliographic search was carried out in Pubmed/Medline, Scopus and Cochrane Library and included articles taking a sample of children between 0 and 18 years of age diagnosed with the abovementioned disorders and including at least one of the following oral hygiene conditions - oral hygiene, dental caries, malocclusion, oral habits, dental trauma, and gingival-periodontal status - comparing them with a healthy population.

Results

A total of 10 articles were obtained for autism spectrum disorder and six for sensory deficits.

Conclusions

Of all the variables studied, only the state of oral, gingival and/or periodontal hygiene can be considered worse in patients with ASD and SD, although we believe a larger number of research studies is needed to corroborate these results.

Key words:Oral health, dental caries, malocclusion, oral habits, dental trauma, oral hygiene, disabled child, autism, autism spectrum disorder, deaf, blind.