Effectiveness of various education methods on oral health knowledge plaque and gingival health among hearing and speech-impaired children - A randomized controlled trial

AIM: To compare the effectiveness of DIY kit intervention of oral hygiene education with visual and caregiver guided education methods among hearing and speech impaired children.

STUDY POPULATION : Hearing and Speech impaired children

RESEARCH QUESTION: Is there any difference in the effectiveness of DIY kit intervention in comparison with visual and caregiver-guided oral health education methods on oral health knowledge, plaque and gingival health among hearing and speech-impaired children?

SAMPLING PROCEDURE: The study subjects will be randomly allocated into three study groups using cluster randomization.

STUDY GROUPS:

The number of groups is 3.

• Group A – (n=18) – DIY kit intervention on oral health education

• Group B – (n=18) – Visual guided education method

• Group C – (n=18) – Caregiver guided education method

SAMPLE SIZE :

The sample size was calculated using G power software version 3.1. The calculation was based on the mean Plaque scores among children with hearing and speech impaired from a previous study conducted by Maria Moin et al (2021) (). With 95% power and alpha error 5%, the minimum sample size was calculated to be 48, n=16 in each group. (ANNEXURE 1). Anticipating a 10% loss to follow up, the sample size is calculated as 18 per group (n=18). Thus, the total sample size N=54

METHODOLOGY :

The study subjects will be selected based on the inclusion criteria and exclusion criteria. The study subjects will be randomly allocated into 3 groups namely Group A, B and C with each group containing 18 participants.

At baseline, Knowledge will be assessed with a newly designed oral health literacy scale which will be assessed for its validity and reliability before beginning the study. The number of correct answers will be summed which gives the score of the newly developed scale. As the score increases, the knowledge increases. Oral Examination: The plaque scores will be assessed using Silness J and Loe H Plaque Index, 1967.  The gingival scores will be assessed using Loe H & Silness J Gingival Index, 1963.

Interventions for Group A:

DIY kit intervention:

• The study subjects will be given DIY kit which contains three activity based oral hygiene education on toothbrushing, diet, and how plaque affects oral health through an experiment.

• The children will be given the instructions of the activity through the sign language.

• The intervention will be given by the primary investigator along with class teacher.

Interventions for Group B:

Visual guided education:

• A visual aid based oral hygiene education will be played.

• The visual aid contains oral hygiene education on brushing technique, diet and about how plaque affects the tooth.

• A video on oral health maintenance will be prepared using sign language with the help of an Indian sign language instructor.

The content of the video will be validated.

Interventions for Group C:

Caregiver guided education:

• The Caregiver will be given oral hygiene education through pamphlet.

• And the caregiver needs to educate the children on oral hygiene education.

All the subjects will be provided with an oral hygiene kit containing a soft bristled toothbrush and fluoridated toothpaste during the study.

Follow up:

Knowledge assessment will be carried out using oral health literacy scale in the three study groups immediately, one week, 15 days and 28 days after intervention. Plaque and gingival index will be assessed on 15th day and 28th day after intervention.