title: Assessment of parental tooth-brushing following instruction with single-headed and triple-headed toothbrushes.
abstract: OBJECTIVE
  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, tooth-brushing ability was re-evaluated and plaque 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 (~86%), than did those in the single-headed group (~61%; P=.001). The plaque index was significantly higher in the single-headed group (0.97±0.38) 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.
authors.affiliation: Faculty of Medicine, Technion, Israel Institute of Technology, and Senior Physician Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Yoel S
authors.initials: YS
authors.lastname: Telishevesky
authors.forename: Liran
authors.initials: L
authors.lastname: Levin
authors.forename: Malka
authors.initials: M
authors.lastname: Ashkenazi
mesh_terms: D002675:Child, Preschool; D006801:Humans; D010290:Parents; D014099:Toothbrushing