Assessment of Parental Tooth-brushing Following Instruction With Single-headed and Triple-headed Toothbrushes

Purpose: The purpose of this study was to evaluate the effect of toothbrush design on the ability of parents to effectively brush their children's teeth. Methods: Parents of children (mean age=5.1 +/- 0.75 years old) from 4 kindergarten schools were randomly assigned to receive instruction in brushing their children's teeth using a manual single-headed toothbrush (2 schools) or a triple-headed toothbrush (2 schools). The parents' ability to brush their children's teeth was evaluated according to a novel toothbrush performing skill index (Ashkenazi Index), based on 2 criteria: (1) placement of the toothbrush on each tooth segment to be brushed ("reach"); and (2) completion of enough strokes on each segment ("stay"). One month after instruction, toothbrushing ability was re-evaluated and plague index of the children's teeth was assessed. Results: One month after instruction, parents using the triple-headed toothbrush received significantly higher scores on the tooth-brushing performance index (similar to 86%), than did those in the single-headed group (similar to 61%; P=.001). The plague index was significantly higher in the single-headed group (0.97 +/- 038) vs the triple-headed group (0.72 +/- 0.29; P<.01). The tooth-brushing performance index correlated negatively with the plaque index (P<.01). Conclusions: A triple-headed toothbrush promotes more consistent tooth-brushing by parents than does a single-headed toothbrush. (Pediatr Dent 2012;34:331-6) Received February 15, 2011 vertical bar Last Revision June 19, 2011 vertical bar Accepted June 21, 2011