Effectiveness of multimodal dental health education with animated cartoons for improving knowledge, attitudes, oral hygiene practices and reducing dental plaque in 7-9 year-old children in Khon Kaen Province

Abstract

Good oral care in children, especially in those aged 7 to 9 years, is important if the risks of later serious dental carries and periodontal  health  problems  are  to  be  minimised.  The  purpose  of  this  study  was  to  evaluate  the  effectiveness  of  an innovative multimodal education programme, which included the use of animated cartoons, to improve knowledge, attitudes and oral hygiene practices of children among this critical age group. The present study was a cluster randomised controlled trial  involving  a  total  of  244  children  selected  from  elementary  classes  in  two  districts  in  Khon  Kaen  Province,  Thailand. The children in one district received the multimodal education programme, while the other district provided the no-treatment controls. The outcome variables comprised measures of dental health knowledge, attitudes to oral care, reported oral hygiene practices, and  an  objective  assessment  of  plaque  formation.  Data  were  analysed  using  multiple  logistic  regression  with  a generalised  estimating  equation  to  estimate  effect sizes in  the  intervention  and  control  groups.

When compared with the controls, the new education programme resulted in statistically significant improvements in all the outcome variables including plaque formation which was the most objective measure of dental care. Recommendations were made for future research.  Two  important  limitations  of  the  study  are  noted:  the  exact  contribution  of  each  of  the multimodal  programme  components  remains  unknown,  in  particular  the  use  of  animated  cartoons,  and  the  lack  of  a long-term  follow-up.