Assessment of Oral Hygiene Status by Intergroup Comparison of Three Different Brushing Techniques in Visually Impaired Children aged 6-12 years: A Prospective Interventional Study

Introduction: Visually impaired children require a specialised form of dental health education that facilitates the learning process for brushing their teeth correctly using effective techniques. The Braille method is a conventional means of education for children with visual impairments. In contrast, the Audio Tactile Performance (ATP) technique is a uniquely developed method for educating these children and has proven to be effective. Aim: To evaluate the oral hygiene status by comparing the Braille and ATP techniques with the Fones method, as well as ATP with the Modified Bass technique of tooth brushing using a conventional dentifrice in visually impaired children, and to assess its impact on the children's daily routines. Materials and Methods: A prospective interventional study was conducted by the Department of Paediatric and Preventive Dentistry at SGT University, Gurugram, Haryana, India, involving 300 blind school children aged 6-12 years from New Delhi-National Capital Region (NCR), India over a period of 18 months from November 2018 to February 2020. The Oral Hygiene Index-simplified (OHI-S) scores were recorded pre- and post-operatively among three groups: Group 1 (conventional Braille method), group 2 (ATP technique with the Fones method), and group 3 (ATP with the Modified Bass method). The data were analysed statistically using Statistical Package for Social Sciences (SPSS) software version 21.0. Intergroup comparisons of oral hygiene status were performed using the Post-hoc Bonferroni correction. A p-value of less than 0.05 was considered significant. Results: The study participants comprised 283 males and 17 females, with a mean age of 8.58 +/- 1.297 years (Mean +/- SD). When comparing the three groups, the OHI-S scores at baseline and one month post-examination were found to be statistically insignificant (p-value >0.05). However, at the 6, 9, and 12-month marks, the mean differences between group 1 (Braille) and group 3 (ATP + Modified Bass) and between group 2 (ATP + Fones) and group 1 (Braille) were statistically significant (p-value <0.001). Conclusion: Groups 2 and 3 demonstrated comparable and superior results in reducing the mean plaque scores at the 12- month follow-up compared to baseline when assessed against group 1, indicating the higher efficacy of the ATP technique over Braille instructions. This study also revealed that group 3 had slightly superior results compared to group 2, although this difference was statistically insignificant. The ATP technique proved to be more effective than Braille instruction in raising awareness of oral health education.