Abstract
This study was performed to evaluate the effects of the types of toothbrushes on tooth brushing and to detect the factors which influence the effect of sell-tooth brushing with physically handicapped children. The subjects were 11 cerebral palsied (3 athetoids and 8 spastics) and 6 others with motor disabilities and ranged between 5 and 19 yeats of age. They used 3 types of tooth brush (Butler 111(1t, Butler; t111 ' with modified resin grip, and electric tooth brushes) each for 2 weeks and the plaque index (Shick & Ash) and the gingival index (Löe) were examined before and after the self-tooth brushing week. We evaluated as the motor functions the grasping force of the more skilful hand, the degree of the disturbance of the voluntary movements of the wrist, the elbow, and the shoulder as well as the co-ordiating abilities of the upper arm. We also evaluated the mental factors, I. Q. using the WISC-R test and motivation from the adaptive behavior scale test. The distribution of the subjects' I. Q. was widely spread from the severely reatrded to the border line area and concerning the disturbance of the voluntary movements,8 subjects had mild and 8 subjects has severe disturbances. The following results were obtained;
1) For the average plaque index before and after the self-tooth brushing week, there were no statistically significant changes with any of the 3 types of brushes.
2) For the average gingival index before and after the self-tooth brushing, a statistically significant improvement was obtained with the electric tooth brush (p<0.05) but was not obtained with the other types.
3) For the rate of improvement of the plaque index and the gingival index, according to variance analysis, there were no statistically significant improvements with any of the 3 types of brushes.
4) For the co-relationship among the motor function factors, between the grasping force and the plaque index a statistically significant co-relationship was obtained (p<0.05) with the electric brush, and group with a mild disturbance of the voluntary movements showed a much better oral hygiene condition than those with severe disturbances for the 3 types of toothbrush but the statistically significane was not obtained.
5) For the mental factors, between the I. Q. and the plaque index there was no statistically significant co-relationship but between the score of ABS and the plaque index some co-relationship was discovered except the electric tooth brush.
We think the motivation of handicapped children is a very important factor with regards to self-toothbrushing.
