Effectiveness of visual pedagogy in improving toothbrushing skills, oral hygiene and gingival health among children with autism- A randomised controlled trial.

BACKGROUND: Autism is a neurodevelopmental disability that diminishes social interactions and communication. Maintaining good oral hygiene in them is a significant task. OBJECTIVES: The objective of this study was to evaluate the effectiveness of a toothbrushing visual pedagogy (TBVP) in improving brushing skills, oral hygiene, and gingival status among children with autism. MATERIALS AND METHODS: This cluster randomized controlled trial was conducted among 200 children with autism, aged 6-17 years. TBVP and conventional oral hygiene instructions were administered as an intervention in the test group (TBVP). The control group (oral health education [OHE]) received conventional oral hygiene instructions. Assessment of toothbrushing skills, plaque, and gingival status were carried out at baseline, 30-, 60-, and 90-days. The data were analyzed using t-tests in SPSS version 26 software at P < 0.05. RESULTS: At baseline, there was no significant difference between the groups in toothbrushing skills, plaque, and gingival scores. Postintervention, there was a significant improvement in the TBVP group compared to the OHE group. At 90 days, the mean toothbrushing scores of TBVP group were significantly higher (22.49 +/- 6.70) than the OHE group (18.35 +/- 6.82). Plaque scores were significantly lower (1.31 +/- 0.48) in the TBVP group than the OHE group (1.47 +/- 0.50). Gingival scores were significantly lower (1.38 +/- 0.48) in the TBVP group than the OHE group (1.56 +/- 0.51) (P < 0.05). CONCLUSION: The TBVP was effective in improving the toothbrushing skills, oral hygiene, and gingival health of the children with autism. Hence, it can be used for behavioural guidance in toothbrushing for these children to maintain their oral hygiene.