Effectiveness of dental health education on oral hygiene among hearing impaired adolescents in India: A randomized control trial

Enhancing Oral Hygiene in Children With Hearing Impairment: The Impact of Skit Video Interventions -A Randomized Controlled Trial

Aim. This study aimed to assess the effectiveness of 3 interventions-skit video, pictorial, and sign language-in improving the oral hygiene of children with hearing impairment. Materials and Methods. Sixty children randomly divided into 3 groups: Skit video, Pictorial, and Sign language. The mean gingival and Oral Hygiene Index scores were recorded before and after interventions. A 1-way ANOVA was used for statistically significant difference between pre and post intervention scores. Results. A significant difference in mean oral hygiene and gingival index scores before and after interventions was found in Group A (P < .005). A statistically significant difference was also found between group A and B in inter group comparison of OHI and GI scores post intervention (P < .004). Conclusion. Skit video and pictorial intervention effectively improves oral health resulting in reduced mean oral hygiene and gingival scores.

Oral hygiene status in individuals with hearing difficulties: A systematic review and meta-analysis

OBJECTIVES

Most studies focusing on oral hygiene status in hearing impaired individuals are cross-sectional and focus on specific populations. A comprehensive literature search and evidence-based analysis was carried out to assess the oral hygiene status in this special group of population.

METHODS

Searches were conducted in four databases with no restriction on publication date. Cross-sectional and comparative cross-sectional studies assessing the oral hygiene status and periodontal status of hearing impaired individuals using standardized evaluation criteria were included. Study selection, data extraction, and assessment of bias were carried out by four reviewers and oral hygiene, plaque, and gingival status were assessed. The risk of bias assessment was carried out by New Castle Ottawa Quality Assessment Scale. 29 relevant publications that fulfilled the eligibility criteria were included in the systematic review whereas six studies each assessing oral hygiene and plaque status and five studies evaluating the gingival status were included in the Meta-analysis.

RESULTS

Eight thousand eight hundred and ninety (8890) potentially relevant references were identified in the systematic literature search. The overall analysis of the included studies revealed a mean oral hygiene index score of 1.60 (95% CI 0.91-2.30), Gingival Index scores 1.27 (95% CI 1.02-1.51), and Plaque Index score 0.99 (95% CI 0.75-2.30) among the hearing impaired individuals.

CONCLUSION

The present study reported fair oral hygiene, fair plaque status, and moderate gingivitis among the hearing impaired individuals.

Visual learning strategies for oral health promotion and treatment interventions in children and adolescents with hearing impairment - A systematic review

AIM

People with hearing impairment (HI) prefer visual learning strategies in daily activities owing to their reliance on vision. The aim of this systematic review is to evaluate the effectiveness of visual learning as a communication strategy in improving oral hygiene and dental care of children and adolescents with HI.

METHODS AND RESULTS

Four electronic databases were searched and complemented by hand searching for original intervention studies published till December 2021. Eligible studies were screened, data was extracted as per priori data collection form and analyzed by thematic content analysis. The quality of studies was assessed as per the validated tools appropriate for study designs including ROB2, ROBINS-I, and NIH quality assessment tool. Out of 4159 records identified and 1302 duplicates removed, 24 original studies were identified and the visual learning strategies were classified into sign language, visual aids with or without sign language, customized educational demonstrations and the interim role of training the teachers. These strategies helped in improving oral hygiene status, oral health-related knowledge and attitude as well as dental anxiety during treatment. Participants were found to be satisfied with these strategies, however, significant heterogeneity in the included studies precluded meaningful meta-analysis. ROB2 and ROBINS were rated as high and serious in all included trials, respectively, and NIH Quality Assessment Tool for Pre-Post Studies With No Control as fair in five studies and poor in three.

CONCLUSION

Our findings emphasize the significance of visual learning, however, long-term rigorously designed trials are needed to better understand effective and patient-centered communication methods for people with HI.

Impact of the Visual Performance Reinforcement Technique on Oral Hygiene Knowledge and Practices, Gingival Health, and Plaque Control in Hearing- and Speech-Impaired Adolescents: A Randomized Controlled Trial

This study aimed to evaluate the impact of oral health education (OHE), incorporating a novel pre-validated visual performance reinforcement (VPR) technique and sign language, on gingival health, plaque control, and oral hygiene knowledge and practices in 12 to 15-year-old hearing- and speech-impaired adolescents. A double-blinded randomized controlled trial was conducted in a government school for deaf children in Belagavi, Karnataka, India. A total of 80 adolescents, aged 12-15 years, were randomly assigned, using a computer-generated table of random numbers, into two groups: Group A receiving the VPR technique (n = 40), and Group B receiving sign language (n = 40). A specially designed pre-validated closed-ended questionnaire was administered to both groups, followed by clinical examination to obtain the gingival and plaque index, before intervention and at a 16-week follow-up period. Group A showed a significant increase in the knowledge gained when compared to Group B. Similarly, a significant improvement in oral hygiene practices was also observed in Group A. However, at the 16-week follow-up, there were no statistically significant differences in gingival and plaque scores between the groups. OHE using the VPR technique can be as effective and satisfactory as sign language in the reduction of gingival and plaque scores and in the improvement of knowledge and its application in oral hygiene maintenance among hearing- and speech-impaired adolescents.

Factors affecting provision of oral health care for people with special health care needs: A systematic review

Background

Special health care needs (SHCNs) individuals experience higher levels of dental problems including accessing oral health (OH) facilities. Improving standard of OH care in SHCNs requires identifying barriers and enablers. The aim of this study was to perform a systematic review of prior researches to identify OH care barriers and enablers for SHCN individuals.

Methods

Electronic searching was conducted systematically in PubMed and Cochrane databases. The PICOS parameters were formulated for the inclusion of studies, and the PRISMA method was used to select the articles. Two reviewers independently screened the articles for eligibility and to minimise the risk of bias in the studies and also searched the contents of key articles, quality of methodology, outcomes and reference lists of all the studies included.

Results

A total of 1316 (PubMed 956, Cochrane 360) studies were found initially and after title and abstract screening and also removal of duplication, reviewers selected 53 papers from PubMED and 19 articles from Cochrane to go through full articles and led to the final confirmation of 21 studies. Common challenges included lack of OH knowledge and awareness, difficulty in accessing treatment, transportation problem, treatment cost, and lack of inter-professional collaboration for specialized services. Potential solutions included OHE training and services for patients and caregivers, easy access to dental services, specialized dental practitioners and use of a combination of expertise to meet the demands of SHCN individuals.

Conclusion

This brief analysis will establish dental obstacles to the provision of information to policymakers for SHCN population at organizational, individuals and policy levels. It will help in effective planning for providing and improving OH care quality in caregivers.

Provision of dental services for vulnerable groups: a scoping review on children with special health care needs

Background

The provision of dental services for children with special health care needs (CSHCN) needs to be considered by policymakers. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group.

Methods

A review was conducted applying the 9-steps approach. Five scientific databases of PUBMED, SCOPUS, Web of Science and PROQUEST and EMBASE were searched up to 10.07.2021, applying appropriate keywords. Thematic analysis was used to analyse the extracted data, and a conceptual map was developed according to JBI manual for evidence synthesis.

Results

From the abstracts of the 136 articles that fulfilled the inclusion criteria, 56 articles were included. Five main themes were identified as determinants affecting the provision of dentistry services for CSHCN, including needs assessment, policy advice, oral health interventions, providers’ perception and access barriers. According to the developed conceptual map, assessing the needs of CSHCN can lead to particular policy advice. Regarding the policies, appropriate oral health interventions can be presented. These interventions, along with providers’ perception about service delivery to CSHCN and the barriers to access them, determine the provision of dentistry services for CSHCN.

Conclusions

An effective needs assessment of CSHCN and their parents/carers can lead to evidence-informed policymaking and applicable policy advice according to the needs. Then policymakers should develop interventions to improve the community’s health literacy, as well as support the seeking behaviours for appropriate services. Policymakers should also consider how to limit the barriers to accessing oral and dental health by CSHCN to decrease disparities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07293-4.

Impact of Oral Health Educational Interventions on Oral Hygiene Status of Children with Hearing Loss: A Randomized Controlled Trial

Introduction

Oral health is considered as one of the essential components of the overall health of every individual. Maintaining oral health is a gradual process that requires commitment. Children who require special care such as hearing impairment experience difficulty in maintaining oral health primarily due to communication difficulties. This study is aimed at using different interventions to evaluate the improvement of oral hygiene in hearing impaired children.

Materials and Methods

Fifty-nine children were recruited in this study that were allocated randomly into each group with twenty children as follows: group 1: pictorial, group 2: video, and group 3: control. Mean plaque and gingival scores were noted before and after the use of different interventions. Oral hygiene was categorized as “excellent,” “good,” and “fair.” Gingival health was categorized as “healthy,” “mild gingivitis,” and “moderate gingivitis.”

Results

Thirty-four children (57.6%) were from 12-13 years of age bracket, and 25 (42.4%) belonged to 14-16 years of age. Regarding gender, there were 37 (62.7%) males and 22 (37.3%) females. About comparison of mean gingival and plaque scores before and after interventions in each group, a significant difference was found in group 1 (p < 0.001) and group 2 (p < 0.001), as compared to group 3 where the difference in scores was not significant (p > 0.05).

Conclusion

Maintaining oral health requires the compliance of individuals to perform different methods of preventive dentistry, such as tooth brushing and use of dental floss. The use of different oral hygiene educational interventions such as pictorial and video methods have been proven and useful for hearing impaired children in improving oral health.

Evaluation of a specially-designed educational and interventional programme on institutionalized visually impaired children: A prospective interventional study

AIM

The aim of this study was to design, implement, and to evaluate the success of an oral health care programme specially designed for visually impaired children over a 12-month period.

DESIGN

A structured questionnaire collected information regarding oral health knowledge and practices of the study population. A specially designed oral health education programme was conducted for the children and their teachers and reinforced after 1, 3, 6, 9, and 12 months. The oral health status of the children was assessed and scored at baseline examination and after each follow-up visit. Independent t-test and paired t-test were used for comparison of scores. Spearman's correlation test was used to measure the correlation between knowledge and practices scores with oral hygiene status.

RESULTS

The study population (5-16 years) had good knowledge about oral health which, however, did not translate into everyday practices. The overall oral hygiene scores declined from 2.06 ± 1.20 at the preliminary examination to 1.24 ± 0.79 at the end of 12 months (p < 0.001).

CONCLUSION

The customized oral-health education programme was efficacious in improving the oral health of the visually impaired children, and the repetition and reinforcement components of this dental health education programme were of significant value in enhancing their oral health.

Comparison of impact of oral hygiene instructions given via sign language and validated customized oral health education skit video on oral hygiene status of children with hearing impairment

INTRODUCTION

Children with special health-care needs have limitations in oral hygiene performance due to their potential motor, sensory, and intellectual disabilities and so are more prone to have compromised oral health.

AIM

This study aimed to compare the impact of oral hygiene instructions given via sign language and a validated customized oral health education skit video on oral hygiene status of children with hearing impairment (CHI).

SETTINGS AND DESIGN

Ethical clearance was obtained from the institutional ethical committee for research activities. The study was carried out across CHI schools of Wardha district, Maharashtra, India.

METHODOLOGY

Sixty-eight CHI, within the age group of 6-13 years, were divided into two educational intervention groups: customized oral health educational video (Group A) and sign language (Group B). A structured questionnaire was designed to gather information about the routine oral hygiene practices via the Indian Sign Language. Baseline Gingival Index (GI)-S and Plaque Index-S indices were recorded. Based on the group assigned, oral hygiene instructions were given on a daily basis. Reassessment was done after 4 weeks.

STATISTICAL ANALYSIS

Unpaired t-tests were performed (P < 0.05) to determine if significant differences exist between the two groups.

RESULTS

Postintervention plaque scores between Group A and Group B were 0.12 ± 0.22 and 0.07 ± 0.22, respectively, and the difference between the two was statistically insignificant (P = 0.330). For GI, scores in Group A and Group B were 0.03 ± 0.12 and 0.04 ± 0.12, respectively, and the difference was statistically insignificant (P = 0.669).

CONCLUSION

Both sign language and the validated customized video modeling have been proved to be positively influencing the oral hygiene status of CHI equivalently.