Date Published: October 10, 2018
Publisher: Public Library of Science
Author(s): Denis Bourgeois, Ina Saliasi, Claude Dussart, Juan Carlos Llodra, Delphine Tardivo, Laurent Laforest, Manuel Bravo, Stéphane Viennot, Bruno Foti, Florence Carrouel, Ratilal Lalloo.
The aim of this study was to evaluate the effectiveness of a preclinical oral prophylaxis education program by examining the effectiveness of the teaching module on changes to the students’ attitudes towards their individual hygiene behaviors with interdental brushes (IDBs).
As being part of a new didactic program on oral interproximal prophylaxis, all preclinical third-year students (n = 96) enrolled in the 2014/15 academic year received theoretical, preclinical, and clinical lessons on interproximal prophylaxis. The evaluation of educational outcomes was linked to observed changes in students’ hygiene behaviors using interdental brushes. Knowledge, skills, attitudes, satisfaction, competence and performance were also explored. The evaluation interviews were recorded at each recall, i.e., 1 week, 1 month, 3 months and 1 year after baseline.
Motivation to use IDBs is clearly related to the perception of the effectiveness of the brushes and the perception of bleeding reduction. At one week, 89.6% of subjects reported using IDBs. Individual use decreased significantly from one week to one month (-26%, p = 0.006) while a non-significant upward trend occurred between one month and three months. Among students reporting usage of IDBs at 1 year (20.8%), only 2.0% used IDBs daily. Most students would recommend IDBs to other people at the beginning (69.8%). However, this share dropped to 50% at 3 months. IDB-users prescribed more than non-users.
The implementation of a module on interdental hygiene practices in the oral health program is strongly recommended. However, corrective measures should be considered regarding the organization and frequency of recall periods in order to improve the performance of the curriculum.
Oral conditions, as chronic diseases, are highly prevalent, affecting 3.9 billion people. Severe periodontitis conditions evaluated for the entire Global Burden of Diseases 2010 Study were the 6th most prevalent conditions, affecting 11% of the global population . Periodontal disease is a component of the global burden of chronic disease . It is characterized at its onset by a synergistic and dysbiotic microbiota in which different members or specific gene combinations fulfill distinct roles that converge to shape and stabilize a disease-provoking microbiota .
To the best of our knowledge, this study is the first to report on an objective assessment of prophylaxis interdental biofilm interventions in a dental education setting. It also evaluated the consistency of the module in terms of its effectiveness on knowledge and attitudes relevant to the clinical practice of students as well as the content validity of the information. The major teaching objective of the IIOPEP was to promote the daily use of calibrated interdental brushes to disturb biofilms from adolescents to seniors without periodontal diseases using an assimilated technique. Our goal is also to make students aware that the daily use of IDBs has the same clinical value and logic as the use of a toothbrush.
The newly developed and applied curriculum has a positive effect on the interdental hygiene practices of the dental students using IDBs. After the curriculum, more students recommend IDBs to more people despite the fact that only a small number of students continuously use interproximal devices. Motivation to use IDBs is related to the perception of the effectiveness of brushes and the perception of bleeding reduction. Introducing this module into the dental curriculum for pre-clinical students will have a large clinical effectiveness in preventive strategies because the knowledge, skills and clinical practice will enable students to efficiently manage the interdental biofilms of their future patients. At this stage of our experience, we recommend the use of the module on interdental hygiene practices in the oral health curriculum of dental faculties.