title: Manual toothbrushing reinforced with audiovisual instruction versus powered toothbrushing among institutionalized mentally challenged subjects--a randomized cross-over clinical trial.
abstract: OBJECTIVE
  To assess and compare the effectiveness of Manual toothbrushing reinforced with audiovisual instructions with powered toothbrushing, among the institutionalized mentally challenged individuals under supervision of trained caretakers.
  
  
  METHODS
  A randomized cross over clinical trial of 6 months duration which included 16 subjects consisting of two phases of three months, for each of the 2 groups. In group A subjects were given manual toothbrushes with audio-visual aid followed by the powered toothbrushes & vice versa for group B. All subjects were instructed by trained care takers. An evaluation of the plaque & gingival scores was done at the end of 1, 2 & 3 months for both the groups.
  
  
  RESULTS
  Phase I showed statistically significant decrease in mean plaque scores (p=0.037) but insignificant mean gingival scores (p=0.189) in group A at end of 3 months. In phase II, statistically insignificant decrease in mean plaque & gingival scores were recorded at end of 3 months. In group B a statistically significant decrease in both plaque (p=0.002) & gingival (p=0.001) was found at end in both phases. Comparison of mean plaque & gingival scores of manual & powered toothbrushes at different intervals in both groups were statistically insignificant.
  
  
  CONCLUSIONS
  For mentally challenged individuals, manual toothbrushes reinforced with audio-visual instructions for brushing may be comparable to the use of powered toothbrushes.
authors.affiliation: Department of Periodontics, Bhojia Dental College & Hospital, Baddi-17035 Himachal Pradesh, India. drsachin82@gmail.com
authors.forename: Sachin
authors.initials: S
authors.lastname: Goyal
authors.forename: Betsy S
authors.initials: BS
authors.lastname: Thomas
authors.forename: Khandige Mahalinga
authors.initials: KM
authors.lastname: Bhat
authors.forename: G Subraya
authors.initials: GS
authors.lastname: Bhat
mesh_terms: D000293:Adolescent; D000328:Adult; D001296:Audiovisual Aids; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D007326:Institutionalization; D008607:Intellectual Disability; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D016037:Single-Blind Method; D014099:Toothbrushing / Q000295:instrumentation*; D055815:Young Adult