The relationship between self-management skills and toothbrushing behavior in schoolchildren

Objectives: The aim of this study was to investigate the relationship between self-management skills (SMS) and toothbrushing behavior, as well as knowledge of gingivitis in schoolchildren. Methods: Eighty children (age of 10-11 years) were examined for gingival condition and plaque accumulation in the anterior teeth. Number of sites with papillary bleeding index³a1, pocket depth³a3mm and plaque score were assessed in each child. They were also asked to fill out two kinds of questionnaires (Q1, Q2). Q1 contained 10 items about attitude to their daily life, in order to estimate their SMS. Q2 contained 18 items about behavior, attitude and knowledge of dental health. Each child was scored using answers of Q1. The score was graded into 1-4 by quartile, which indicated higher SMS in descending order. Answers of every item in Q2 were classified into two categories (CA): whether or not to have good influence on dental health. The distribution of children was analyzed using Mann-Whitney test based on 2x4 tables consisting of CA and SMS grades for every 18 items of Q2. Gingival condition and plaque score by SMS grade was analyzed using Kruskal-Wallis test. Results: The gingival condition and plaque score was not related to SMS grade. Six items: - experience of bleeding, acknowledgement of brushing skill, expectation of brushing, acquisition of refreshment after brushing, confirmation of cleanliness after brushing, careful brushing - were significantly related to SMS grade (p<0.05). Children with higher SMS showed the tendency of reporting better habits and feelings. Conclusion: It can be considered that children with lower SMS felt not much interest in and expectation to tooth brushing, and thus they are at high risk for gingivitis, even if they don't show signs of gingivitis yet. Accordingly, SMS grade may be a useful indicator to identify the children at high risk of gingivitis.