A music- and game-based oral health education for visually impaired school children; multilevel analysis of a cluster randomized controlled trial

Oral health in youth with visual impairment: A longitudinal survey

This longitudinal survey aims to demonstrate improvement in oral hygiene among a group of youth with visual impairment (VI) achieved by repeated oral hygiene training, compare their progress with healthy peers (CG) and assess their oral health knowledge. In 100 VI (55♀, 45♂; ± 17.8 years) and 45 CG (23♀, 22♂; ± 17.2 years) oral hygiene training and a Quigley-Hein Plaque Index (QHI) rating were repeated six times at three-month intervals. The VI were divided into four subgroups according to the toothbrush hardness/type. A questionnaire was given to both groups. Appropriate statistical analyses were performed at 5% significance level. Both groups showed reduction in QHI, the VI had overall higher QHI values than CG. Use of an electric toothbrush in VI led to lower QHI in the last examination (p < 0.03). 69% of participants recommended dental specialists to improve communications by acquiring more illustrative aids. VI changed toothbrush less often (p < 0.02). A higher incidence of dental plaque was confirmed in VI compared to CG. After education and individual training, gradual plaque reduction has occurred in both groups. Using an electric toothbrush in VI resulted in better QHI outcomes. Repetitive preventive intervention in youth with VI helped them to adopt healthier oral hygiene habits.

Impact of oral health preventive program using specialized audio and tactile aids in visually impaired school children. A cross-sectional study

BACKGROUND

The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children.

MATERIALS AND METHODS

100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices.

STATISTICAL ANALYSIS

Independent 'T-test' was used for comparing mean ± SD values.

RESULTS

Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3rd and 6th months.

CONCLUSION

The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children.

Comparison of Different Modes of Oral Health Education in Visually Impaired Children

To compare the effectiveness of various modes of oral health education in visually impaired children. A total of 100 students aged 8-15 years were included. The children were divided randomly into four groups. Children in Group I received oral hygiene instructions through Braille pamphlets. In Group II, children received instructions through nonvisual desktop access (NVDA). For children in Group III, both Braille and NVDA were used to deliver the instructions. Children included in Group IV served as controls, who did not receive any information in any form for the study period. After oral examination to record plaque and OHI-S scores, a questionnaire was given to the children to assess their knowledge scores. The same questionnaire was repeated after 1 month to reassess the knowledge score in different groups. Chi-square test, Wilcoxon test, and post hoc analysis tests were used. The mean plaque scores among the control group children at the follow-up were significantly higher (2.5 ± 0.64) than any other group. Similarly, the control group had higher mean oral hygiene simplified scores (1.75 ± 1.32) than the Braille (1.12 ± 0.65), NVDA (0.85 ± 1.38), and Braille + NVDA (0.2 ± 0.64) groups at follow-up. With regards to the mean total knowledge score, the control group scored the least (2.16 ± 1.46), while the Braille, NVDA, and Braille + NVDA groups scored 3.16 ± 1.43, 4.52 ± 1.12, and 6.36 ± 0.52, respectively. Combination of Braille and NVDA was found to be effective in educating and motivating visually impaired children regarding maintenance of oral hygiene.

Unleashing the most effective oral health education intervention technique for improving the oral hygiene status and oral health knowledge in visually impaired young individuals: A systematic review and meta-analysis

Appropriate oral health education (OHE) plays a vital role in prevention of oral diseases and would bridge the gap between dentists and visually impaired individuals. Hence, this systematic review was planned with an aim to evaluate effectiveness of various OHE techniques on the oral hygiene status and oral health knowledge of visually impaired young individuals. An electronic search extended to September 30, 2020 was conducted on PubMed, Wiley, ProQuest, ScienceDirect, Cochrane library, EBSCO, and Google Scholar. Two independent reviewers assessed the studies using a two-stage process; data were extracted according to PRISMA statement. Risk of bias assessment of selected studies was executed according to the study designs. Meta-analysis using the random-effects model was conducted for the outcomes for all oral health education techniques using STATASE 16.1 software. Hand and electronic search identified 3829 articles. After screening for titles and duplicates, 37 articles were retrieved, which were screened through abstract and full text. Of the 37 articles, 17 articles were included for qualitative synthesis, and out of that, 13 were for meta-analysis. Ten variations in oral health education (OHE) techniques were used in the included 17 studies to impart oral health education to visually impaired young individuals. Overall, all OHE techniques demonstrated a positive impact on oral hygiene status. The pooled overall cumulative mean difference of the oral hygiene status after imparting education in ATP, Audio, and Braille was 1.33 [1.06, 1.59], 1.76 [1.11, 2.42], and 1.96 [1.40, 2.55], respectively. An appropriate OHE technique boosts confidence in visually impaired young individuals, making the learning process an enjoyable experience. Use of either Braille or the ATP OHE technique was found to be a reliable and useful method to improve oral hygiene of visually impaired young individuals.

Effectiveness of an online application of the health action process approach (HAPA) theory on oral hygiene intervention in young adults with fixed orthodontic appliances: a randomized controlled trial

Background

This randomized controlled trial aimed to evaluate the effectiveness of an online application based on HAPA theory on oral hygiene promotion in young adults with fixed orthodontic appliances.

Methods

A WeChat mini-program (called “Clean Teeth”) based on HAPA theory was designed beforehand to improve oral-health behaviors and oral hygiene, and 44 participants aged 17–29 with fixed orthodontic appliances were recruited. Participants of the experimental group (n = 22) received the “Clean Teeth” mini-program, in addition to care as usual, and the control group (n = 22) only received routine oral health education. Data were collected during three orthodontic check-ups: baseline (T0), 6 weeks of follow-up (T1), and 12 weeks of follow-up (T2). All participants completed questionnaires assessing oral health behaviors and the psychosocial factors of the HAPA model and accepted the clinical examinations involving the dental plaque index and the gingival bleeding index.

Results

After a 12-week intervention, the plaque index and gingival bleeding index in the experimental group were significantly lower than that in the control group. The psycho-social parameters of social effects, expected outcomes, and action control were improved significantly after treatment, among which social effects increased significantly only in the experimental group but not in the control group.

Conclusions

The HAPA theory-based mini-program had positive effects on oral-health behavior promotion and oral hygiene among young adults with fixed orthodontic appliances.

Trial registration This study was retrospectively registered in the Chinese Clinical Trial Registry, with the number CTR2200056731, dated 12/02/2022. http://www.chictr.org.cn/index.aspx.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02219-w.

TECNOLOGIAS PARA EDUCAÇÃO EM SAÚDE DE PESSOAS COM DEFICIÊNCIA VISUAL: REVISÃO INTEGRATIVA

RESUMO Objetivo: investigar as evidências científicas acerca das tecnologias existentes e/ou que são utilizadas para educação em saúde de pessoas com deficiência visual. Método: revisão integrativa realizada nas bases de dados MEDLINE/PubMed, CINAHL, LILACS, via Biblioteca Virtual em Saúde, Web of Science, Scopus e Cochrane Library, em novembro de 2021. Resultados: identificaram-se 18 artigos, dos quais oito estudos foram publicados em periódicos de enfermagem. Acerca dos países que foram locais de pesquisa, dez estudos foram publicados no Brasil e os demais em países como Estados Unidos, Irã, Índia, Turquia e Portugal. Os temas mais abordados pelas tecnologias foram saúde sexual e reprodutiva e saúde bucal. Os demais versaram sobre amamentação, saúde ocupacional, hipertensão arterial, diabetes e drogas. Quanto aos tipos de recursos de acessibilidade empregados nas tecnologias, prevaleceu o uso do áudio, através de texto ou CD, em dez estudos, e de recursos que exploraram o sentido tátil do cego, por meio de protótipos didáticos anatômicos, manuais educativos com figuras em alto relevo e texturas diferentes, em nove artigos. Outros recursos de acessibilidade foram audiodescrição, tecnologias mediadas pelo uso da internet e/ou do computador e materiais impressos em Braille. Predominaram estudos metodológicos e, em quatorze estudos, ocorreu a aplicação da tecnologia com as pessoas com deficiência visual. Conclusão: os estudos mostraram adequabilidade e viabilidade das tecnologias desenvolvidas para educação em saúde de pessoas com deficiência visual, por oferecerem conhecimento sobre os temas propostos e igualdade de acesso a materiais educativos para este grupo.

HEALTH EDUCATION TECHNOLOGIES FOR PEOPLE WITH VISUAL IMPAIRMENT: INTEGRATIVE REVIEW

ABSTRACT Objective: to investigate scientific evidence about existing health education technologies for people with visual impairment. Method: integrative review performed in MEDLINE/pubmed, CINAHL, LILACS databases, via Virtual Health Library, Web of Science, Scopus and Cochrane Library, in November 2021. Results: 18 articles were identified, of which eight were published in nursing journals. Regarding the countries that were research sites, ten studies were published in Brazil and the others in countries such as the United States, Iran, India, Turkey and Portugal. The most addressed themes of the technologies were sexual and reproductive health and oral health. The others were about breastfeeding, occupational health, hypertension, diabetes and drugs. Regarding the types of accessibility resources used in the technologies, the use of audio, through text or CD, prevailed in ten studies, and resources that explored the tactile sense through anatomical didactic prototypes, educational manuals with embossed figures and different textures, in nine articles. Other accessibility features were audio description, technologies mediated by the use of the Internet and/or computer, and braille printed materials. Methodological studies predominated and, in fourteen studies, the application of technology with visual impaired people occurred. Conclusion: the studies showed adequacy and feasibility regarding the health education technologies developed for people with visual impairment, because they offer knowledge about the proposed themes and equal access to educational materials for this group.

Effectiveness of oral health education methods on oral hygiene in children and adolescents with visual impairment: A systematic review

BACKGROUND

Conventional methods of oral health education (OHE) are not suitable for children with visual impairment, as these methods usually involve visual demonstration with models or plaque-disclosing dyes.

AIM

To systematically review the literature to support the best approach for providing OHE to children and adolescents with visual impairment.

DESIGN

A systematic search of five electronic databases and grey literature was conducted. Randomized controlled trials that compared different OHE methods in children and adolescents with visual impairment were included. The Cochrane risk-of-bias tool (RoB 2) was used for the risk-of-bias assessment. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used to determine the certainty of evidence.

RESULTS

Nine randomized controlled trials with a total of 804 participants were included in this review. Seven OHE methods were compared. Seven studies were assessed to be at high risk of bias, one study was assessed to have some concerns, and one study was assessed to be at low risk of bias. The overall certainty of evidence was very low according to GRADE.

CONCLUSION

There was insufficient evidence to recommend a particular method of OHE as more effective in improving the oral hygiene of children with visual impairment, but combination methods may show similar or better results.

Eficacia de los programas de musicoterapia: un metanálisis cualitativo

Resumen El aumento de enfermedades transmisibles justifica la necesidad de verificar la eficacia no farmacológica de los tratamientos alternativos. La música promueve las interacciones sociales y el trabajo en grupo, ayuda en varios aspectos del aprendizaje humano, la emoción y la memoria, y puede convertirse en una herramienta terapéutica complementaria. El objetivo de este estudio fue analizar la evidencia de la eficacia de la musicoterapia como tratamiento no farmacológico mediante un diseño descriptivo retrospectivo utilizando como parámetros de búsqueda: “musicoterapia” o “programas musicales” y “salud” en las bases de datos Scopus y Web of Science. Entre los principales resultados, destacamos que los programas de intervención que utilizan la música como tratamiento coadyuvante no farmacológico en enfermedades no transmisibles ofrecen resultados positivos y significativos sobre la mejora de las patologías en las que interviene. A partir de estos resultados, sería importante ampliar la formación de los profesionales de la salud en la aplicación de técnicas basadas en el arte y específicamente en la musicoterapia.

New vision for improving oral hygiene status of visually impaired students aged from 9 to 17 years

Background:

Visually impaired patients are at a higher risk of developing periodontal disease because of greater difficulty in attaining good oral hygiene. This study aims to assess and compare the oral hygiene status of visually impaired students before and after oral health education interventions using special customized methods.

Methods:

The present study was a randomized control trial of 180 visually impaired students divided into three groups. Each group includes 60 students selected randomly from blind school. Oral health education was given using Braille in Group 1, Audio Tactile performance (ATP) technique in Group 2, and a combination of Braille and ATP technique in Group 3. Plaque index (PI) scores and gingival index (GI) scores were calculated and evaluated at baseline and after 3 months. Intergroup comparison and intragroup comparison of PI and GI at baseline and 3 months was by using one way ANOVA and Paired t test, respectively.

Results:

There was a highly significant difference seen for the intergroup comparison of post PI (P < 0.01) and post GI (P < 0.01) with least mean in Group 3. There was a statistically highly significant difference seen for the intra group comparison of pre and post PI and GI (P < 0.01) with lesser means in post as compared to pre in all three groups.

Conclusions:

Visually impaired children could maintain an acceptable level of oral hygiene when taught using combination of Braille and ATP technique.