Using video observation to understand oral hygiene behaviour – how do 18-year-olds brush their teeth?

Abstract

Background: Due to German prophylaxis programmes provided from kindergarten until the age of 18 years they are suspected to be able to brush their teeth sufficiently at the age of 18. However, earlier research indicates that they apparently don’t. In order to better understand potential reasons, a video analysis of tooth brushing behaviour was performed. Methods: N=96 18 year-olds were instructed to brush their teeth as good as possible while being videotaped. Afterwards, a dentist assessed oral cleanliness (percentage of sites without plaque). The videos were analyzed by two calibrated observers with respect to brushing duration, brushing locations (in total 12) and brushing movements (horizontal, circular, vertical). Findings: Participants brushed their teeth on average for 207±9 seconds. However, oral cleanliness was achieved at only 30±12% of sites. When splitting the whole mouth into 12 regions of interest, only 10 participants managed to brush all these regions by more than 5 seconds while 50% reached no more than 7 out of 12 by that time. Even though horizontal movements are not those predominately recommended ones, a considerable percentage (40±29%) of brushing time was spent by such movements. Discussion: Data analyses indicate problems in teaching children a systematic brushing behaviour. Even though they learn to spend a considerable time with brushing this brushing time is not evenly distributed across all regions of interest. This apparently results in persistent plaque. The present research demonstrates that a thorough analysis of behaviour performance might be a necessary step in behaviour education and health psychology interventions.