Effectiveness of supervised toothbrushing and oral health education in improving oral hygiene status and practices of urban and rural school children: A comparative study
Open accessAbstract
OBJECTIVE: To evaluate and compare the oral health status and the impact of supervised toothbrushing and oral health education among school children of urban and rural areas of Maharashtra, India. MATERIALS AND METHODS: A total of 200 school children in the age group 12-15 years were selected by stratified random sampling technique from two schools and were further divided into two groups: Group A (urban school) and Group B (rural school). Both the groups were again subdivided into control group and study group. Supervised toothbrushing was recommended for both the groups. The toothbrushing teaching program included session on oral health education, individual toothbrushing instructions, and supervised toothbrushing. Dental caries increment, plaque scores, and gingival status were assessed as per the World Health Organization (WHO) criteria (1997), Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index, and Loe-Silness Gingival Index (1963), respectively. Cronbach's alpha, Chi-square test, paired t-test, and unpaired t-test were utilized for data analysis. RESULTS: The mean plaque and gingival score reduction was significantly higher in the study groups as compared to the control groups. An increase in the mean of Decayed, missing, filled teeth (DMFT) and Decayed, missing, filled teeth and surfaces (DMFS) scores throughout the study period was seen in children who participated in study. CONCLUSION: Oral health education was effective in establishing good oral health habits among school children and also in enhancing the knowledge of their parents about good oral health.
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Community-level programmes, such as school-based supervised toothbrushing initiatives, have demonstrated effectiveness in reducing caries incidence, particularly among children.
“Community-level programmes, such as school-based supervised toothbrushing initiatives, have demonstrated effectiveness in reducing caries incidence, particularly among children.10”
From Mapping evidence on implementation research in oral health: a global scoping review protocol (2026) · cites this paper as [10]
The Discussion (Evaluation of DMFT and DMFS scores; page not provided) reports no statistically significant difference in caries increment between the study and control groups. The paper found improvements in oral hygiene, but its school-based programme did not demonstrate the claimed reduction in caries incidence. (LLM, conf=0.89)
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Experimental — accuracy not yet measuredInitiatives incorporating supervised toothbrushing and organized oral health education significantly improve adherence and oral hygiene outcomes, particularly among school-aged children.
“Initiatives incorporating supervised toothbrushing and organized oral health education have shown a significant improvement in adherence and oral hygiene outcomes, particularly among school-aged children [41].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [41]
The Results (page unavailable) report significantly greater reductions in plaque and gingival scores in the intervention groups than in controls after three months. The Conclusion (page unavailable) says the program established good oral hygiene habits in schoolchildren, but the paper does not report a statistically significant improvement in adherence specifically. (LLM, conf=0.85)
Experimental — accuracy not yet measuredParticipants in school-based toothbrushing programs exhibited significant improvements in oral hygiene, gingival health, and caries prevention compared to their non-participating peers.
“A comparative study examining urban and rural schoolchildren indicated that participants in school-based toothbrushing programs exhibited significant improvements in oral hygiene, gingival health, and caries prevention compared to their non-participating peers [41].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [41]
The Abstract Results report significantly greater reductions in plaque and gingival scores in the study groups than in controls, supporting the oral-hygiene and gingival-health parts of the claim. But the Discussion section “Evaluation of DMFT and DMFS scores” says there was no statistically significant difference in caries increment between study and control groups, so the claimed significant improvement in caries prevention is not supported. (LLM, conf=0.93)
Experimental — accuracy not yet measuredInteractive mobile applications and gamification are effective in engaging children and supporting the continuation of their oral hygiene practices.
“The incorporation of technology in oral health education, demonstrated through interactive mobile applications and gamification, has proven effective in engaging children and supporting the continuation of their oral hygiene practices.”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [41]
The Conclusion (page unavailable) reports that oral hygiene instruction and supervised toothbrushing helped establish good oral hygiene habits in schoolchildren. Materials and Methods (page unavailable) describes models, charts, and live demonstrations—not mobile applications or gamification. The paper does not establish that those technologies engage children or sustain their practices; it recommends further study of long-term effects. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAtraumatic restorative treatment has gained significant recognition, particularly in low-resource settings where access to conventional restorative procedures including rotary instruments and anesthesia is limited.
“ART has gained significant recognition, particularly in low-resource settings where access to conventional restorative procedures, including rotary instruments and anesthesia, is limited [41].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [41]
The Discussion describes supervised toothbrushing in rural schools where oral-health facilities are limited, but it does not address atraumatic restorative treatment. Searches for ART, rotary instruments, anesthesia, and restorative treatment found no passage supporting the attributed claim. Page numbers are unavailable in our copy. (LLM, conf=0.78)
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References 25 · Cited by 85
Research works printed but not linked: 1
- [8]Nizel AE Nizel AE Nutrition counseling for dental caries prevention: A step by step procedure Nutrition in Preventive Dentistry 2013 Philadelphia, PA WB Saunders Company 356
- Authors
- Damle, S., Patil, A., Jain, S., Damle, D., & Chopal, N.
- Affiliations
- Maharishi Markandeshwar University, Mullana (IN)
- Corresponding author
- Damle, SatyawanG
- ORCID
- Patil, Anil
- Venue
- Journal of International Society of Preventive and Community Dentistry
- Published
- 2014
- Volume
- 4
- Issue
- 3
- Pages
- 175
- ISSN
- 2231-0762 (ISSN-L)
- PMC
- PMC4209617
- OpenAlex
- W2076632915
- Cited by
- 85
- References
- 25
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 13 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 9 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 6
- FWCI
- 6.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by-nc-sa
- Locations
- Journal of International Society of Preventive and Community Dentistry (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
- Keywords
- supervised toothbrushing, oral health education, elementary school students, urban-rural comparison, dental plaque, gingival status, dental caries, oral hygiene habits, Maharashtra
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