The Open Dentistry Journal

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Effectiveness of Randomized Controlled Field Trial Instructing Parents to Supervise Children on Tooth Brushing Skills and Oral Hygiene

Shukuru Zacharias1, Febronia Kokulengya Kahabuka2, *, Hawa Shariff Mbawalla2
1 School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
2 Department of Orthodontics, Paedodontics and Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania



Educating parents on supervision of tooth brushing ensures effective plaque removal, healthy gums and attainment of tooth brushing skills.


To evaluate the effect of educating parents about children’s tooth brushing supervision on their own knowledge and act of supervision, their children’s tooth brushing skills, plaque score and gingival health.


Two arms cluster randomized controlled field trial among 8-9 years primary school pupils and their parents. The intervention trial was an educational leaflet on step by step supervision of children during tooth brushing. The outcomes were; improved tooth brushing skills, oral hygiene status and gingival health, parental awareness and supervision of children’s tooth brushing. Data processing and statistical analysis was done using SPSS version 20.0. Frequency distribution for proportions, cross tabulations with Chi-square and adjusted binary logistic regression were performed.


A total of 237 pupils were followed to completion of the study. The odds of parents being aware and supervising children during tooth brushing were higher in the intervention group at follow-up 4.5 (1.5, 13.4) and 2.4 (1.3, 4.5) respectively. The unadjusted odds for good oral hygiene following intervention was 3.1 (1.4, 6.9) and that of tooth brushing skills 61.8 (7.7, 498.6). On adjusting with parental awareness and supervision of children during tooth brushing, odds of having tooth brushing skills increased to 88.2 (9.2, 847.4).


Providing education to parents on children tooth brushing supervision effectively improved children’s tooth brushing skills, plaque score and gingival health emanating from awareness and act of supervision improvements revealed on their part.

Key words: Supervised tooth brushing, Tooth brushing skills, Oral hygiene, Gingival health, Parental instructions, Parental awareness.

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 76
Last Page: 84
Publisher Id: TODENTJ-13-76
DOI: 10.2174/1874210601913010076

Article History:

Received Date: 10/12/2018
Revision Received Date: 11/01/2019
Acceptance Date: 06/02/2019
Electronic publication date: 28/02/2019
Collection year: 2019

© 2019 Zacharias et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthodontics, Paedodontics and Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, United Nations Road, 3rd Floor Room 303, P.O. Box 65014, Dar es Salaam, Tanzania; Tel: +255-222 150 564; Fax: +255-222 150 465;E-Mail:,

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