EFFECTIVENESS OF ASSISTED TOOTHBRUSHING ON PRESCHOOLERS’ ORAL HYGIENE: A CAREGIVER-INTERVENTION APPROACH

Abstract

Objective

To assess the effectiveness of an intervention on caregivers' assisted toothbrushing techniques and oral health maintenance for preschool-aged children, and to determine whether these effects differ by age.

Methods

A single group pre/post intervention study was conducted among children aged 3-5 years and their caregivers in Callao, Peru. Eligible caregivers were trained on assisted toothbrushing using large and real-scale typodonts, along with practical demonstrations by a dentist. Additionally, they were instructed on healthy practices and oral health in children. Children's oral hygiene status (OHS) was assessed using the Simplified Oral Hygiene Index (OHI-S) at baseline and three months postintervention. To assess the effectiveness and quantify the magnitude of the difference between the OHI-S before and after the intervention, we used Wilcoxon signed-rank test and the Cliff's Delta test, respectively. Results were stratified by age group to examine potential differences.

Results

The sample (n = 210) predominantly comprised 3-year-old Peruvian females, primarily cared for by their mothers, who identified as single mothers who had not previously received instruction in oral hygiene practices. We found improvement in children's OHI-S in most age groups. Specifically, among 3-year-olds, the OHI-S score improved significantly from 'fair' (m = 2.6, ± 0.2, range 2.4-2.8) to 'good' (m = 1.1, ± 0.2, range 0.9-1.3). The intervention showed a moderate effect size (δ = −0.15, 95% CI −0.18, −0.10) in the 3-year-olds and a moderate effect size (δ = −0.05, 95% CI −0.08, −0.01) in the 4-year-olds. No significant improvements were observed in the 5-year-old group.

Conclusion

A caregiver-focused intervention significantly improved OHS among preschool-aged children, particularly in younger age groups. Substantial improvements in OHI-S scores were noted for 3- and 4-year-olds, while age-specific factors may have limited efficacy in the 5-year-old group. These findings highlight the importance of early, targeted oral health education for caregivers.