Impact of the Brush Day & Night Programme on Well-Being, Plaque, and Dental Caries in Children

Abstract

Objectives: Poor oral hygiene can have an adverse effect on quality of life. School-based interventions can establish positive behaviours that reduce the likelihood of dental caries later in life. The Brush Day & Night programme aims to encourage good oral health behaviour and improve oral health and quality-of-life outcomes. In this article, we report the effect of the programme on well-being and oral hygiene measured by plaque levels at 3, 8, and 24 weeks and dental caries at 24 weeks after programme start date.

Methods: This was a superiority cluster randomised trial of children 6-12 years of age from Indonesia (N = 2021) and Nigeria (N = 2104). All children were provided with toothpaste and a toothbrush. Children in the intervention group received the 21-day Brush Day & Night programme, whereas those in the control group did not. Children completed a questionnaire addressing the objectives at all time points. Their oral hygiene was assessed using the Oral Hygiene Index-Simplified (OHI-S). Additionally, at baseline and 24 weeks their caries status was recorded using the decayed, missing, and filled teeth (DMFT) index.

Results: In Indonesia, after participation in the programme children demonstrated a 45% increased probability of no worsening in the occurrence of decayed, missing, or filled teeth. In Nigeria, children had a 71% higher probability of having confidence in their smile and the proportion of children with good oral hygiene doubled from 40% to 80% at 24 weeks.

Conclusions: The Brush Day & Night programme was successful in improving well-being and oral hygiene in children in Nigeria and reduced the likelihood of worsening in the occurrence of decayed, missing, or filled teeth in children in Indonesia.

Keywords: Brush Day & Night; Dental caries; Oral hygiene; Quality of life.

Fig. 1

Study flowchart for the Nigeria study. *Number of children code incomplete (without identification of school and grade).

Fig. 2

Effect of Brush Day & Night programme or control on change in quality of life, well-being, and social measures of schoolchildren from Indonesia and Nigeria at Weeks 3, 8. and 24 compared with baseline (FAS). (A) Reporting of confidence when smiling. (B) Reporting of not feeling bullied. BDN = Brush Day & Night FAS = full analysis set; QoL = quality of life.

Fig. 3

Effect of Brush Day & Night programme on well-being and oral health in schoolchildren from Nigeria at Weeks 3, 8, and 24 compared with control (FAS). BDN = Brush Day & Night; FAS = full analysis set. *Adjusted for child's age and school location.

Fig. 4

Proportion of children with good oral hygiene by OHI-S score in the Nigeria study. OHI-S = Oral Hygiene Index-Simplified. *Statistically significant difference in proportions relative to baseline (P value < .05 from McNemar's test).

Fig. 5

Change in OHI-S score category according to baseline status in the Nigeria study. OHI-S = Oral Hygiene Index-Simplified.

Fig. 6

Change in DMFT score by assigned group in the Nigeria study. DMFT = decayed, missing, or filled teeth.

Fig. 7

Study flowchart for the Indonesia study.

Fig. 8

Effect of BDN programme on well-being and oral health in schoolchildren from Indonesia at Weeks 3, 8, and 24 compared with control (FAS). BDN = Brush Day & Night; FAS = full analysis set. *Adjusted for child's age and school location.

Fig. 9

Proportion of children with good oral hygiene by OHI-S score in the Indonesia study. OHI-S = Oral Hygiene Index-Simplified. *Statistically significant difference in proportions relative to baseline (P value < .05 from McNemar's test).

Fig. 10

Change in OHI-S score category according to baseline status in the Indonesia study. OHI-S = Oral Hygiene Index-Simplified.

Fig. 11

Distribution of DMFT by evaluation moment and assigned group in the Indonesia study. DMFT = decayed, missing, or filled teeth.

Fig. 12

Change in DMFT by assigned group in the Indonesia study. DMFT = decayed, missing, or filled teeth.