Dental Plaque Removal with Two Special Needs Toothbrushes in Patients with Down Syndrome: A Parallel-Group Randomised Clinical Trial of Efficacy.

PURPOSE: To compare the effectiveness of two varieties of special needs toothbrushes in terms of dental plaque removal and bacterial contamination vs a conventional toothbrush in patients with Down syndrome. MATERIALS AND METHODS: This single-blinded, two-group, randomised clinical trial included 16 patients diagnosed with Down syndrome (age 6-15 years) from various special needs centers located in the Jazan Province of Saudi Arabia. The patients were randomly allocated to two groups based on the type of special needs toothbrush provided (Collis Curve or superfine nano). The plaque and bleeding indices of the patients in both groups were measured at baseline (T0) and both groups were initially given a conventional toothbrush to use for four weeks. After this period, the plaque and bleeding indices were re-evaluated (T1). The patients were instructed to use the special needs toothbrush for 4 weeks, after which the periodontal indices were re-evaluated (T2). Microbial contamination on the bristles of the special needs brushes was evaluated at T2. RESULTS: No notable changes in the mean plaque and bleeding indices were observed between the two groups at each visit; however, statistically significant reductions were noted between visits in both groups (p < 0.05). The CFU scores in cultures from the Collis Curve toothbrush bristles (1411.5 ± 541.1) were higher than those obtained from the superfine nano-toothbrush bristles (1118.3 ± 423.9), but without statistically significant differences. CONCLUSION: The findings indicate that the use of special needs toothbrushes can statistically significantly improve the gingival health status in individuals with Down syndrome in terms of both resolution of periodontal inflammation and reduction of plaque accumulation.

The Role of Applied Behavior Analysis to Improve Knowledge on Oral Hygiene Practices among Cooperative Autistic Children: A Cross-Sectional Study from Jazan, Saudi Arabia.

OBJECTIVE: To assess the effectiveness of Applied Behavior Analysis (ABA) to improve knowledge regarding oral hygiene practices among cooperative autistic children. MATERIALS AND METHODS: A cross-sectional study was conducted among 15 children between the age group of 6-12 years and their parents who were randomly chosen from a special care autistic school in Jazan, Saudi Arabia. A mobile application was custom designed and programmed with videos on oral hygiene. A close-ended questionnaire comprising 14 questions for the cooperative autistic children and 21 questions for their parents was designed to assess their knowledge in relation to oral health and hygiene. After four weeks, a questionnaire-based knowledge assessment was conducted. The mean knowledge score was then calculated for children and their parents and compared using paired sample t-test. RESULTS: Poor knowledge regarding oral hygiene practices was revealed among the study participants. The estimated mean score among the children was 4.73 before the intervention, which significantly increased to 9.0. The estimated mean score for the parents was 9.3 before intervention and 14.6 after four weeks' period (P < 0.0001). CONCLUSION: The application of ABA using avatars and delivered through videos can significantly improve knowledge regarding oral health hygiene among cooperative autistic children.