Effectiveness of jigsaw puzzle assisted visual reinforcement technique on toothbrushing knowledge, practices and clinical parameters of hearing and speech-impaired adolescents: A single-blind randomized controlled trial.

Background: Oral health education (OHE) for hearing and speech-impaired (HSI) adolescents relies heavily on sign language. However, it is not effective in conveying oral health concepts due to communication barriers, resulting in suboptimal oral health outcomes. This study aims to evaluate the impact of the jigsaw puzzle assisted visual reinforcement (JPVR) technique on toothbrushing knowledge, practices, and clinical parameters among HSI adolescents.

Methods: The study was carried out as a single-blind randomized controlled trial in a public school in Belagavi, India for a period of three months. The study included 95 participants who were randomly allocated into two groups. One group received sign language with JPVR technique, and the other group received only sign language. A self-designed 15-item closed-ended questionnaire (Cronbach's alpha value of 0.88; content validity ratio = 0.85) was developed to assess the knowledge, and practices at baseline and 3 months. Plaque and gingival indices were also recorded.

Results: At the end of 3 months, the knowledge gained and practices improved in JPVR group were significantly higher compared to sign language group (p = .001). The mean plaque score was significantly lower in JPVR group than that in the sign language group (p = .001); however, gingival index did not show any statistically significant difference at 3 months.

Conclusion: The current study demonstrated that OHE utilizing JPVR technique led to significant improvements in toothbrushing knowledge, practices, and plaque scores compared to that of conventional sign language. This promising strategy has the potential to be cost-effective and does not incorporate specialized sign language training for health professionals.