A comparative evaluation of oral hygiene using Braille and audio instructions among institutionalized visually impaired children aged between 6 years and 20 years: A 3-monthfollow-up study

Impact of oral health preventive program using specialized audio and tactile aids in visually impaired school children. A cross-sectional study

BACKGROUND

The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children.

MATERIALS AND METHODS

100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices.

STATISTICAL ANALYSIS

Independent 'T-test' was used for comparing mean ± SD values.

RESULTS

Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3rd and 6th months.

CONCLUSION

The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children.

Effectiveness of Oral Health Education Interventions Using Braille on Oral Health among Visually Impaired Children: Proposal for a Systematic Review

To assess how oral health education (OHE) techniques using braille affect visually impaired children's awareness of oral health, oral hygiene status and practices, plaque, gingival health, and dental caries status. From 2010 to 2020, a thorough literature search will be conducted for studies in the English language using PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar, and Open Grey. Data extraction will be done after two reviewers extensively evaluate the papers for qualifying requirements. In accordance with the research designs, a quality evaluation of the chosen studies will be conducted. With the use of the program Review Manager 5.3, a meta-analysis will be completed.

Assessing effectiveness of braille and audio-tactile performance technique in improving oral hygiene status of young adults with visual impairment

INTRODUCTION

Young adults with Visual impairment (VI) challenge the dentists' skills and knowledge due to a higher risk of developing oral diseases due to difficulty in attaining good oral hygiene (OH).

AIMS

To assess the effectiveness of ATP (Audio-Tactile Performance) technique and braille versus braille alone in improving OH status of young adults with VI.

METHODS AND MATERIAL

A parallel arm, randomized controlled trial was conducted among 70 young adults with VI. Participants were randomly allocated to either test group (braille combined with ATP) or control group (braille alone). A pre-validated braille questionnaire was used to obtain the baseline data followed by clinical examination. OH status assessment was recorded through Gingival Index (GI) and Plaque Index (PI) proforma followed by a thorough ultrasonic oral prophylaxis. Periodic reinforcement was carried out on the 7th day, after 1 month and 3 months. The outcomes were assessed at the end of 3rd and 6th month.

RESULTS

There was an increase in the knowledge scores after 3 and 6 months and attitude scores, GI scores and PI scores after 6 months in the test group compared to the control group and this difference was found to be statistically significant.

CONCLUSIONS

The findings of this study showed that a combination of ATP and braille proved to be more effective than braille alone in improving the knowledge and OH status of young adults with VI.

The Comparison of Anxiety Tactile Using the RMS Tactile Scan in Visually Impaired Children After Performing Oral Prophylaxis by Explaining to Them the Procedure by Verbal Tactile Method

Background

Dental anxiety assessment for blind children is important. Appropriate knowledge of the patient's anxiety will help to review management options specific to every child.

Aim

The aim of this study was to evaluate the anxiety level using the Raghavendra, Madhuri, Sujata (RMS) tactile scale (RMS-TS) of visually impaired children after explaining the oral prophylaxis procedure verbally and by the verbal-tactile method followed by performing the oral prophylaxis procedure.

Materials and methods

A total of 30 children aged between 6 and 13 years were included in this study from a residential school for visually impaired children. These children were divided into two equal groups. One group was explained oral prophylaxis by verbal method and another was explained in a verbal-tactile method, preintervention and postintervention anxiety of the children was checked on the RMS-TS.

Results

A comparison of mean values between the two groups was done using a t-test. Comparison of mean values in each group for before and after values were done using paired t-test and was found that anxiety had reduced in the verbal-tactile group more significantly than that of the verbal group.

Conclusion

The study shows that the combination of verbal and tactile models for explaining the dental procedure is an effective way to reduce anxiety in blind children.

How to cite this article

Kumbar S, Rathod SA, Patil AT, et al. The Comparison of Anxiety Tactile Using the RMS Tactile Scan in Visually Impaired Children After Performing Oral Prophylaxis by Explaining to Them the Procedure by Verbal Tactile Method. Int J Clin Pediatr Dent 2023;16(4):551-554.

Unleashing the most effective oral health education intervention technique for improving the oral hygiene status and oral health knowledge in visually impaired young individuals: A systematic review and meta-analysis

Appropriate oral health education (OHE) plays a vital role in prevention of oral diseases and would bridge the gap between dentists and visually impaired individuals. Hence, this systematic review was planned with an aim to evaluate effectiveness of various OHE techniques on the oral hygiene status and oral health knowledge of visually impaired young individuals. An electronic search extended to September 30, 2020 was conducted on PubMed, Wiley, ProQuest, ScienceDirect, Cochrane library, EBSCO, and Google Scholar. Two independent reviewers assessed the studies using a two-stage process; data were extracted according to PRISMA statement. Risk of bias assessment of selected studies was executed according to the study designs. Meta-analysis using the random-effects model was conducted for the outcomes for all oral health education techniques using STATASE 16.1 software. Hand and electronic search identified 3829 articles. After screening for titles and duplicates, 37 articles were retrieved, which were screened through abstract and full text. Of the 37 articles, 17 articles were included for qualitative synthesis, and out of that, 13 were for meta-analysis. Ten variations in oral health education (OHE) techniques were used in the included 17 studies to impart oral health education to visually impaired young individuals. Overall, all OHE techniques demonstrated a positive impact on oral hygiene status. The pooled overall cumulative mean difference of the oral hygiene status after imparting education in ATP, Audio, and Braille was 1.33 [1.06, 1.59], 1.76 [1.11, 2.42], and 1.96 [1.40, 2.55], respectively. An appropriate OHE technique boosts confidence in visually impaired young individuals, making the learning process an enjoyable experience. Use of either Braille or the ATP OHE technique was found to be a reliable and useful method to improve oral hygiene of visually impaired young individuals.

A comparative evaluation of oral health status among institutionalized totally blind children using different methods - A randomized clinical trial

Background

To compare and evaluate the oral hygiene status among institutionalized visually impaired children using the Verbal, Braille, and Audio-Tactile method.

Materials and Methods

The present study was a single-blinded, randomized clinical trial with a total of 96 visually impaired children both male and female, aged 6-16 years old were included in this study from a residential school for blind. They were divided into three groups: Group 1 - Verbal method, Group 2 - Braille method, and Group 3 - Audio-Tactile method. Baseline oral hygiene scores were recorded using the debris index, calculus index, gingival index and hand scaling was performed for all the children. Fone's brushing technique was taught to all the groups and fluoridated toothpaste was given to the children with 3 and 6 months of follow-up. Periodic reinforcement of oral hygiene instructions was done for each group. The collected data were tabulated and analyzed using the ANOVA test with (P < 0.01).

Results

There was significant improvement in debris index, gingival index, and calculus index in all the three groups by the end of 6 months. All the three indices showed improvement in oral hygiene.

Conclusion

Visually impaired children could maintain a respectable level of oral hygiene when taught specialized methods. However, periodic reinforcement is mandatory for good oral hygiene maintenance. Hence, it is recommended to use the combination of Verbal, Braille, and Audio-Tactile method for the best treatment outcomes in these special children.

A music- and game-based oral health education for visually impaired school children; multilevel analysis of a cluster randomized controlled trial

Background

Visually impaired children encounter some challenges for their oral health. We aimed to compare the effectiveness of oral health education using Audio Tactile Performance (ATP) technique alone, ATP combined with oral health education for mothers, and ATP along with art package on the oral health status of visually impaired children.

Materials and methods

This cluster, randomized trial, included visually impaired children from preschool to 10th grade (32 classes, n = 200), in Tehran, Iran, in 2018–2019. A questionnaire was filled out through face to face interviews at baseline regarding age, gender, status of visual impairment, and place of residence. The Simplified Oral Hygiene Index (OHI-S) and Bleeding on Probing (BOP) were examined afterward. Classes were randomly assigned to three groups through simple randomization: 1. Art group (ATP, game-based, and music-based education (11 classes, n = 66); 2. Mothers group (children received ATP and their mothers received education by telephone (10 classes, n = 73); and 3. Control group (children received ATP (11 classes, n = 61). Children received reinforcement after 1 and 2 weeks. Follow-up oral examinations were performed after 1 and 2 months by a blind calibrated examiner. Descriptive statistics were performed using Chi-Square, and ANOVA tests by SPSS (version 22). In analytic statistics, two-level mixed-effects models for BOP and OHI-S were fitted using the Statistical Analysis Software (SAS) version 9.4. Both models fitted with the grouping variable and time (baseline, 1, and 2 months after interventions) as the fixed effects.

Results

The mean age (SD) of the children was 12.29 (3.45) years (range: 6–17). Male children (67%) more than female children (33%) participated in the study. Also, 35.5% were blind, and 12% resided at the dormitory. The art and mothers groups had no statistically significant difference compared with the control group, in terms of OHI-S (P = 0.92, and 0.39, respectively) and BOP (OR = 0.64, and 0.66, respectively). The time effect was statistically significant in both BOP and OHI-S models (P < 0.0001).

Conclusions

ATP technique is an effective method to improve the oral health status of visually impaired school children. Oral health promotion programs can be done using this method to tackle oral hygiene problems in visually impaired children.

Trial registration

(https://www.irct.ir/trial/34676: Nov 29th, 2018)

Effectiveness of oral health education program using braille text in a group of visually impaired children-before and after comparison trial

CONTEXT

Vision is the most important sense for interpreting the world and when sight is impaired, especially in childhood it can have detrimental effects on one's life. To maintain the oral health status of such group requires special approach.

AIM

The aim of this study is to evaluate the impact of Braille text and verbal, oral hygiene instructions on the oral health status of visually impaired children.

SETTINGS AND DESIGN

A prospective nonrandomized before and after comparison trial without any control group was conducted among 165 children aged 7-19 years residing in one of the blind schools in Delhi.

MATERIALS AND METHODS

A questionnaire was developed to record the source of oral health knowledge and practices. Oral health status of the children was evaluated by recording plaque index (PI) and gingival index (GI) scores at 1, 3, and 5 months intervals. Periodic reinforcement of oral health education was performed with the help of instructions in Braille language.

STATISTICAL ANALYSIS

Paired t-test and McNemar tests were used to assess the difference between the scores before and after oral health education.

RESULTS

Among completely blind children, the mean difference of PI and GI score from baseline to the last evaluation was found to be 0.56 and 0.28, whereas among partially blind children, it was found to be 0.58 and 0.25, respectively. All the above values were statistically significant (P < 0.001).

CONCLUSION

Visually impaired children irrespective of the degree of blindness could maintain an acceptable level of oral hygiene when taught using Braille text for instructions. However, continuous motivation and reinforcement at regular intervals are required for the maintenance of oral health status.

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.