Effectiveness of Audio-Tactile Performance Technique With Sing-Along Lyrics on Oral Hygiene Instruction to Visually Impaired Individuals: A Matched-Pair Randomized Study

Mahidol University40 enrolled

Overview

The goal of this match-pair randomized study is to compare the effectiveness of the standard Audio-Tactile Performance (ATP) technique with a song-based adaptation (ATP/S) in teaching oral hygiene in visually impaired individuals aged 6 to 20 years in Kathmandu, Nepal. 1. Can the ATP/S approach achieve a greater improvement in plaque control, as measured by the Patient Hygiene Performance (PHP) index, compared to standard ATP instruction over a two-week period? 2. Does the rhythmic structure of a song lead to a more continuous improvement in toothbrushing task performance and theoretical oral health knowledge? Researchers will compare a control group receiving standard ATP with an audio information file to an intervention group receiving ATP with a sing-along song to see if rhythmic auditory stimuli help regulate sequencing and reduce working-memory demands during complex motor tasks.

This study is divided in to 2 groups where visually impaired individuals are allocated after inclusion and exlusion criteria. In this matched-pair randomized study, 40 VI participants aged 6-20 years were allocated to ATP or ATP/S groups. Outcomes were assessed at baseline, immediately post-intervention, and at two-week follow-up using the Patient Hygiene Performance (PHP) index, a 16-step toothbrushing task analysis, and an eight-item oral health knowledge questionnaire. Intra-group changes were analyzed using the Friedman test; inter-group comparisons used the Mann-Whitney U test (p \< 0.05).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Eligibility

Sex: ALLMin age: 6 YearsMax age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Bilateral visually impaired in age 6-20yrs. (as verified in school medical record) Exclusion Criteria: 1. Visual impairment associated with any disabilities that affected arm motor skill/loss of upper dexterous extremity/abnormal mental development/deaf. 2. Using any chemical plaque control agent. 3. Individuals with calculus on examining teeth 4. On medications that could affect the gingival status. 5. Inability to brush due to pain from severe caries/oro-mucosal conditions. 6. Have less than 4 teeth in each quadrant. 7. Presented with orthodontic or prosthodontic appliance. 8. Subject with good oral hygiene ; plaque score = 0 9. Un co-operative children.

Outcomes

Primary Outcomes

tooth brushing task analysis

The oral cavity is divided into 16 surface areas. Scoring Criteria: For each area, participants are scored on four specific criteria: 1. Maintaining a 45-degree angle of the bristles. 2. Using an appropriate back-and-forth vibrating motion. 3. Ensuring adequate surface coverage. 4. Brushing for at least 5 seconds per surface. Calculation: Each correctly executed criterion earns 1 point, and the total skill level is determined by the percentage of points achieved out of the total possible points.

Time frame: from baseline to intervention, reinforment (1 week) & Final data collection (end of 2 weeks)

Secondary Outcomes

Patient hygiene performance (PHP score)

The secondary outcome evaluates the objective effectiveness of the brushing by measuring the amount of dental plaque (debris) left on the teeth. The Process: Teeth are stained with erythrosin dye, which highlights plaque. Scoring Method: Six specific index teeth are examined, with each tooth surface divided into five sections. Binary System: A section receives a 1 if debris is present and a 0 if it is absent. Calculation: The final PHP score is the sum of these points divided by the number of surfaces examined; a lower score indicates better oral hygiene.