Psychomotor skills and incentive as predictors in a children's toothbrushing program

Sixty-four children, four to twelve years of age, were seen in a pediatric dental clinic for routine dental examinations. Prior to dental treatment subjects were administered tests of visual-motor development and dental knowledge. Children were randomly assigned to a toothbrushing-instruction (individual training in horizontal scrubbing) or no-instruction group. Within each group, subjects were assigned to an incentive (promise of a special prize for brushing well) or no-incentive condition. Plaque score measurements and toothbrushing skills evaluations were performed at the initial appointment and at a one-week follow-up. Brushing skills were predicted by visual-motor skills and by dental knowledge. Level of visual-motor development predicted the likelihood of missing fewer oral areas, while brushing incentive was found to affect overall improvement in plaque removal regardless of instruction. Instruction affected improvements in brushing the more difficult molar teeth and lingual surfaces specifically.