Jutta Margraf-Stiksrud

What Is the Best Predictor for Oral Cleanliness After Brushing? Results From an Observational Cohort Study

BACKGROUND Brushing performance is an important factor for brushing success. Thus, observing brushing performance might help to explain deficits in oral hygiene. However, it is unknown how brushing behavior observed at one time relates to brushing capabilities observed at another time. The authors assessed the predictive validity of video-observed habitual brushing behavior for the capability to achieve oral cleanliness several weeks later. METHODS Study participants (N = 101) were video-recorded while cleaning their teeth. Two independent, calibrated examiners assessed brushing duration, evenness of distribution of brushing time across areas of the mouth as one indicator of brushing systematics, and duration of specific brushing movements. Weeks later (mean: 6.4 weeks; range: 1 to 24 weeks), 70 participants were asked to remove plaque to the best of their ability, and degree of oral cleanliness was assessed immediately afterward. A forward regression analysis was performed to assess the predictive values of brushing parameters. RESULTS Regression analysis revealed that evenness of distribution of brushing time and duration of circling movements explained 20.8% of variance of oral cleanliness (P < 0.001). CONCLUSION Evenness of distribution of brushing time and duration of circling movements are aspects of observed habitual brushing behavior that predict brushing capabilities in terms of oral cleanliness.

Training in different brushing techniques in relation to efficacy of oral hygiene in young adults: a randomized controlled trial.

AIM This study aims to assess plaque scores after oral hygiene in an unselected sample of young German adults and to compare the effects of computer-based training of the Fones versus the modified Bass technique on these scores. MATERIAL AND METHODS Seventy 18- to 19-year olds received computer-based training of the Fones technique, the modified Bass technique or basic instructions of oral hygiene alone (control group). The marginal plaque index (MPI; percentage of sections adjacent to the gingiva showing plaque) and BOP were assessed at baseline and after 6, 12 and 28 weeks. MPI was assessed immediately after participants had been asked to perform oral hygiene to the best of their abilities. RESULTS At baseline, MPI levels of 83.3% ± 12.5 (mean ± SD) were observed. After 12 weeks, groups differed significantly (p < 0.05) with respect to MPI: Fones group: 70.3% ± 14.7; Bass group: 77.91 ± 14.37; control group: 79.3% ± 9.2. No differences in BOP were found. CONCLUSIONS High plaque levels at gingival margins after oral hygiene were observed in an unselected sample of young German adults. After 12 weeks, plaque levels after oral hygiene were slightly reduced in the group who had received training of the Fones technique but effects trailed off afterwards. The study failed to prove effects of the training on signs of gingival inflammation.

Does the ‘Teddy Bear Hospital’ enhance preschool children’s knowledge? A pilot study with a pre/post-case control design in Germany:

The ‘Teddy Bear Hospital’ is a medical students’ project, which has been increasingly established in many countries. To evaluate this concept, we examined the effects of a German Teddy Bear Hospital on children’s knowledge relating to their body, health and disease. Using a quasi-experimental pre/post design, we examined 131 preschool children from 14 German kindergartens with pictorial interview-based scales. The analysis of covariance revealed that the children who visited the Teddy Bear Hospital had a significantly better knowledge concerning their body, health and disease than the children from the control group. This German Teddy Bear Hospital is a good health education vehicle for preschool children.

Psychologie in der Zahnmedizin

Psychologie in der Zahn-, Mund- und Kieferheilkunde hat eine lange Tradition. Bereits in den 20er- und 30er-Jahren des letzten Jahrhunderts beschaftigten sich (Zahn-)Mediziner in Deutschland mit psychologischen Aspekten zahnmedizinischer Erkrankungen, der Psychologie des Zahnarztes und des Patienten und der zahnarztlichen Behandlungssituation (Huppmann u. Kramp 1995; Huppmann 1997). Gleichwohl spielten psychologische Themen in der Ausbildung junger Zahnarzte bisher eine eher kleine Rolle, wenn sie uberhaupt angesprochen wurden. Nach Ketterl (1986) ist »ein guter Zahnarzt schon immer auch ein guter Psychologe« gewesen — auch ohne besondere Ausbildung in Psychologie. Ketterls selbstbewusste Uberzeugung bezieht sich wohl auf eher praktische Fertigkeiten im Umgang mit den Patienten. Sie greift zu kurz, wenn eine fundierte Kenntnis der Gesetzmasigkeiten menschlichen Erlebens und Verhaltens in den Bereichen —Krankheitsentwicklung und -bewaltigung, —Befolgungsverhalten und Kooperation bei zahnarztlichen Masnahmen, —Pravention von zahnmedizinischen Erkrankungen, —Gestaltung der Zahnarzt-Patient-Beziehung und nicht zuletzt —Wahrnehmung und Ausubung der eigenen zahnarztlichen Tatigkeit notig ist, um die Qualitat und den Erfolg der zahnarztlichen Betreuung und Behandlung zu verbessern.

Association between a New Sugar Index and Caries Experience: Results of a Cross-Sectional Field Study

Objectives: The aim of this study was to test the relationship between a newly developed sugar index and caries experience in 4th- and 6th-graders. Materials and Methods: A total of 1,019 fourth-graders and 925 sixth-graders from 2 regions in Northern Germany participated in the study. Caries experience was recorded by applying the ICDAS criteria. Tooth-brushing habits and other independent variables were examined psychometrically. Structured questions were formulated that were related to specific everyday eating situations, especially between main meals, which proved to be relevant for a higher caries risk. To compare mean caries scores, nonparametric tests were applied. The Pearson coefficient was calculated in order to verify the correlation between the sugar index and the caries experience. The influence of various independent variables on caries experience was assessed by stepwise backward logistic regression analysis. Results: With regard to the primary teeth of the 4th-graders, significant correlations with values > 0.1 were found for all ICDAS outcome variables. With regard to the permanent teeth of the 6th-graders, the only significant correlations with the sugar index were for the ICDAS outcome variables D3–6MFT and D3–6FS. Conclusion: The results of our study show that not only the correlation between the sugar index and caries experience was stronger for 4th-graders than for 6th-graders, but also more distinctly visible differences were observed when comparing extreme groups. This indicates that protective factors, such as fluoridation and the preventive sealing of fissures, help level out the differences in caries occurrence in older children when compared to younger children.

Toothbrushing: to the best of one’s abilities is possibly not good enough

BackgroundWeaknesses in toothbrushing performance can be seen when young adults are instructed to perform habitual toothbrushing. Nothing is known about toothbrushing behavior when instructed to perform to the best abilities. The present study analyzes such behavior and compares it to habitual behavior.MethodsA random sample of N = 98 young adults born in 1995 was examined in 2014/2015.They were asked to perform oral hygiene to the best of their abilities in front of a camera. Videos were analyzed regarding details of brushing behavior. A quality index was developed which describes the extent of the neglect of brushing on palatinal and vestibular surfaces. Data were compared to those of an earlier study of young adults (born in 1992, examined in 2011, N = 101) who were asked to perform oral hygiene as they habitually do.ResultsThe 1995 cohort (best abilities) brushed their teeth significantly longer than the 1992 cohort (habitual brushing). This was due to significant longer brushing at vestibular and occlusal surfaces. Neglect of palatinal surfaces was similar in both cohorts. Groups did not differ regarding brushing movements. 40% of the brushing time on lateral surfaces was spent with scrubbing movements despite opposing advice in common oral hygiene instructions.ConclusionsToothbrushing to the best of one’s abilities might still not be good enough. Young adults apparently lack a reasonable concept of what is meant by high quality toothbrushing. More efforts should thus be undertaken to explain them (and adults) this concept.