title: Toothbrushing procedure in schoolchildren with no previous formal instruction: variables associated to dental biofilm removal.
abstract: The aim of this study was to establish the association between features regarding brushing procedure performed by schoolchildren without previous formal training and the effectiveness of biofilm removal. Out of a population of 8900 6- and 7-year-old schoolchildren in Buenos Aires City, 600 children were selected from schools located in homogeneous risk areas. Informed consent was requested from parents or guardians and formal assent was obtained from children themselves. The final sample consisted of 316 subjects. The following tooth brushing variables were analyzed: toothbrush-gripping, orientation of active part of bristles with respect to the tooth, type of movement applied, brushing both jaws together or separately, including all 6 sextants and duration of brushing. The level of dental biofilm after brushing was determined by O'Leary's index, acceptable cut-off point = 20%. Four calibrated dentists performed observations and clinical examinations. Frequency distribution, central tendency and dispersion measures were calculated. Cluster analyses were performed; proportions of variables for each cluster were compared with Bonferroni's correction and OR was obtained. The most frequent categories were: palm gripping (71.51%); perpendicular orientation (85.8%); horizontal movement (95.6%); separate addressing of jaws (68%) and inclusion of all 6 sextants (50.6%). Mean duration of brushing was 48.78 ± 27.36 seconds. 42.7% of the children achieved an acceptable biofilm level. The cluster with the highest proportion of subjects with acceptable post-brushing biofilm levels (p<0.05) differed significantly from the rest for the variable "inclusion of all 6 sextants in brushing procedure". OR was 2.538 (CI 95% 1.603 - 4.017). Inclusion of all six sextants could be a determinant variable for the removal of biofilm by brushing in schoolchildren, and should be systematized as a component in oral hygiene education.
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, University of Buenos Aires, Argentina. glerossi@yahoo.com.ar.
authors.forename: Glenda N
authors.initials: GN
authors.lastname: Rossi
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Ana L
authors.initials: AL
authors.lastname: Sorazabal
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Salgado
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Aldo F
authors.initials: AF
authors.lastname: Squassi
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Graciela L
authors.initials: GL
authors.lastname: Klemonskis
mesh_terms: D018441:Biofilms; D002648:Child; D003773:Dental Plaque / Q000382:microbiology* / Q000517:prevention & control*; D006801:Humans; D011996:Records; D014070:Tooth / Q000382:microbiology*; D014099:Toothbrushing / Q000379:methods*
keywords: Oral hygiene; dental plaque prevention and control; toothbrushing