The Impact of Adaptive Functioning and Oral Hygiene Practices on Observed Tooth-Brushing Performance Among Preschool Children with Special Health Care Needs
- 133 Downloads
To investigate the impact of adaptive functioning and oral hygiene practices on tooth-brushing performance among preschool children with special health care needs (SHCN).
A cross-sectional study was conducted in Special Child Care Centers. Children’s tooth-brushing performance was assessed by a standardized 13-step pro forma. Information regarding children’s socio-economic status, adaptive skills, and oral hygiene practices were collected. Bivariate analysis and ANCOVA were used to explore the potential factors which might be associated with children’s tooth-brushing performance.
The tooth-brushing assessment was provided to 379 children with SHCN. Approximately 3% of the recruited children performed the whole tooth-brushing procedure independently. The number of tooth-brushing steps practiced by those children was 4.47 ± 3.56. Children who had established tooth-brushing habit before age one practiced more tooth-brushing steps than children who brushed their teeth after age one (p = 0.029). When children’s age, gender, and socio-economic status were adjusted, children who had established regular tooth-brushing habit or children who had high levels of adaptive skills showed better tooth-brushing performance than their peers. Children who used gauze, cotton swab, or dental floss to clean their teeth practiced fewer key tooth-brushing steps than their peers who had never used additional cleaning approaches (p = 0.038).
Conclusions for Practice
Children’s tooth-brushing performance was associated with adaptive skills and oral hygiene practices. Tooth-brushing training should be provided to children with SHCN in early childhood. For children who had limitations in adaptive functioning, parental assistance or supervision is recommended to guarantee the efficacy and safety of daily tooth brushing.
KeywordsPediatric Tooth brushing Adaptive functioning Special needs Oral hygiene
We would like to express our deepest gratitude to all the recruited children and their parents for their participation and cooperation. We gratefully acknowledge the staff in the Special Child Care Centers, Ms Cindy YEUNG and Kuen Wai Ma for their excellent assistance in administration of the study. The work described in this paper was fully supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. 17118518).
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Chapple, I. L., Bouchard, P., Cagetti, M. G., Campus, G., Carra, M. C., Cocco, F., et al. (2017). Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: Consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. Journal of Clinical Periodontology, 44, S39–S51.CrossRefGoogle Scholar
- Elison, S., Norgate, S., Dugdill, L., & Pine, C. (2014). Maternally perceived barriers to and facilitators of establishing and maintaining tooth-brushing routines with infants and preschoolers. International Journal of Environmental Research and Public Health, 11(7), 6808–6826.CrossRefGoogle Scholar
- McGrath, C., Yiu, C. Du, R. (2017). Effectiveness of a tooth brushing social story among children with autism. Journal of Dental Research, 96 (Spec Iss A): 0369. Retrieved September 11, 2019 from www.iadr.org.
- Schalock, R. L., Borthwick-Duffy, S. A., Bradley, V. J., Buntinx, W. H. E., Coulter, D. L., Craig, E. M., et al. (2010). Intellectual disability: Definition, classification, and systems of supports (11th ed.). Washington, DC: American Association on Intellectual and Developmental Disabilities.Google Scholar
- Shaghaghian, S., & Zeraatkar, M. (2017). Factors affecting oral hygiene and tooth brushing in preschool children. Shiraz/Iran. Journal of Dental Biomaterials, 4(2), 394–402.Google Scholar
- Zhou, N., Wong, H.M., & McGrath, C.P.J. (2018). Validation of a tooth-brushing visual pedagogy for mentally challenged children. Journal of Dental Research, 97 (Spec Iss B):1126. Retrieved September 11, 2019 from www.iadr.org.
- Zhou, N., Wong, H. M., & McGrath, C. (2019). Effectiveness of a visual-verbal integration model in training parents and their preschool children with intellectual and developmental disabilities to dispense a pea-sized amount of fluoridated toothpaste. Journal of Applied Research in Intellectual Disabilities, 32(3), 657–665.CrossRefGoogle Scholar