Adoption of a toothbrushing technique: a controlled, randomised clinical trial

The aim of this study was to evaluate the implementation of the modified Bass technique (MBT) and a brushing sequence using different instruction methods. Ninety-nine participants, aged 19-42, were randomly assigned to one of three groups (control group: no instruction; leaflet instruction group: verbal instruction using a leaflet; and demonstration group: verbal instruction supported by demonstration with a model, no leaflet). Participants were instructed twice with an interval of 2 weeks. To evaluate the implementation of the technique and brushing sequence, participants were filmed during toothbrushing at baseline and 2 weeks after the first and second instruction, respectively. The duration of brushing was measured. After the first instruction, 19% in the leaflet instruction group and 41% in the demonstration group fully performed the MBT, and 36% in both instruction groups fully adopted the brushing sequence. After the second instruction, 25% of patients in the leaflet instruction group and 62% in the demonstration group had adopted the technique completely. The brushing sequence was adopted by 63% in the leaflet instruction group and by 48% in the demonstration group. Only 16% in the leaflet group and 38% in the demonstration group adopted both the technique and brushing sequence after the second instruction. The results indicate the need to improve instructional strategies.