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Toothbrush deterioration and parents’ suggestions to improve the design of toothbrushes used by children with special care needs

Authors
  • Zhou, Ni1
  • Wong, Hai Ming2
  • McGrath, Colman3
  • 1 Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China , Kunming (China)
  • 2 The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China , Hong Kong SAR (China)
  • 3 The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China , Hong Kong SAR (China)
Type
Published Article
Journal
BMC Pediatrics
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Sep 21, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12887-020-02347-8
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundBiting objects was a parafunctional oral habit among children with special care needs. Chewing or biting toothbrushes could expedite the process of toothbrush wear. However, few studies evaluated the deterioration levels of toothbrushes used by children with special needs. This study aimed to assess the deterioration level of toothbrushes used by children with special care needs, and collect parents’ feedbacks to improve the design of children’s toothbrushes.MethodsThe cross-sectional study recruited 277 children who had special care needs. Children’s toothbrushing behaviors, background information, and parents’ comments on toothbrushes were obtained. Toothbrush deterioration was assessed by bristle wear and bite mark scores. Higher scores indicated severe deterioration.ResultsThree hundred twenty-one toothbrushes were collected. Children who used 2 to 6 toothbrushes in a 3-month period showed higher toothbrush deterioration scores than children who used a single toothbrush. Over 40% children’s toothbrushes presented excessive wear. Excessive wear was associated with social skills and parents’ education background. Distinct bite marks tended to exist on toothbrushes which had been used by children who showed challenging behaviors during toothbrushing (OR = 1.96, 95%CI1.15–3.32, p < 0.05). Approximately 27% parents reported that children’s toothbrushes should be modified. Parents recommended that the size of toothbrush heads, the angle of handles, and the texture/length/distribution/diameter of bristles should be adjusted. Besides, ideal toothbrushes should be able to provide verbal or visual instructions to children, motivate children to brush teeth, simplify toothbrushing procedure, and protect children who had toothbrush-biting habits.ConclusionsExcessive wear and distinct bite marks can be found on toothbrushes that had been used by children with special care needs. Toothbrush deterioration was associated with children’s social skills, toothbrushing behaviors, and parents’ educational attainment. The commercially available toothbrushes should be modified to meet the additional needs of young children.

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