Manual toothbrushing reinforced with audiovisual instruction versus powered toothbrushing among institutionalized mentally challenged subjects-A randomized cross-over clinical trial

Aim: To assess and compare the effectiveness of Manual tooth brushing reinforced with audiovisual instructions with powered tooth brushing, among the institutionalized mentally challenged individuals under supervision of trained caretakers. Materials and Methods: A randomized cross over clinical trial of 6 months duration which included 16 subjects consisting of two phases of three months, for each of the 2 groups. In group A subjects were given manual toothbrushes with audio-visual aid followed by the powered toothbrushes & vice versa for group B. All subjects were instructed by trained care takers. An evaluation of the plaque & gingival scores was done at the end of 1, 2 & 3 months for both the groups. Results: Phase I showed statistically significant decrease in mean plaque scores (p=0.037) but insignificant mean gingival scores (p=0.189) in group A at end of 3 months. In phase II, statistically insignificant decrease in mean plaque & gingival scores were recorded at end of 3 months. In group B a statistically significant decrease in both plaque (p=0.002) & gingival (p=0.001) was found at end in both phases. Comparison of mean plaque & gingival scores of manual & powered toothbrushes at different intervals in both groups were statistically insignificant Conclusion: For mentally challenged individuals, manual toothbrushes reinforced with audio-visual instructions for brushing may be comparable to the use of powered toothbrushes.