Effectiveness of Educational Videos Comparing Single Versus Multiple Topics: A Cluster Randomized Controlled Trial

Background Dental caries and gingivitis are preventable diseases that remain highly prevalent among children globally and, while transmissible through the transfer of oral bacteria typically from mother to child, differ from communicable diseases that are spread through direct contact, air, or vectors. Unlike communicable diseases, dental caries and gingivitis can be effectively prevented through proper oral hygiene practices and dietary modifications. Oral health education (OHE) intends to improve oral hygiene practices and reduce oral health problems. However, evidence of the impact of multiple topics in OHE on preschool children is lacking. This study aimed to examine the effects of single- versus multiple-topic OHE delivered via video presentations on the plaque and gingival status of preschool children. Methods A parallel five-arm cluster randomized controlled trial was conducted on healthy preschool children aged five and six years. Children with chronic illnesses, disabilities, or conditions that could affect their oral health or ability to participate in the OHE intervention were excluded. OHE interventions were given to children from eight of the 10 classes assigned as intervention groups, while two classes served as the control group and received no intervention. The intervention groups received one, two, or three oral health topics using specially developed animation videos, in Malay language: toothbrushing technique (T), toothbrushing technique and the effects of sugar consumption on oral health (TS), toothbrushing technique and pathogenesis of dental caries and gingivitis (TP), and toothbrushing technique, the effects of sugar consumption on oral health, and pathogenesis of dental caries and gingivitis (TSP). Plaque and gingival scores, along with oral health knowledge, attitude, and skills (KAS), were recorded before and after the intervention. The CONSORT guidelines were followed in reporting. The analyses included descriptive statistics, one-way ANOVA, effect sizes, and multivariate analysis of covariance (MANCOVA) at a 5% significance level. Results A total of 160 participants were equally distributed into five groups (n = 32). There were no baseline differences in plaque or gingival scores. All groups showed significantly lower plaque and gingival scores post-intervention (p < 0.05), with effect sizes ranging from -1.1 to -0.7. No changes in oral health (KAS) were observed. The intervention groups had significantly lower plaque and gingival scores compared to the control group (p < 0.05), but no differences were found between them after adjusting for baseline KAS (p > 0.05). Conclusions This study suggests that including multiple topics in OHE programs for preschool children may not necessarily improve oral health outcomes. Simplified OHE may be more advantageous in terms of time, cost, human resources, and organization.