Randomised controlled trial on differential learning of toothbrushing in 6- to 9-year-old children.

OBJECTIVES: This study aimed to evaluate the effect of differential learning of toothbrushing compared to habitual toothbrushing and instruction/demonstration of toothbrushing on plaque reduction and gingival inflammation of primary school children. METHODS: Children (6-9 years) were subjected to a toothbrushing training consisting of 15 days (3 × 5 days, interval 2 days, 3 min/day) and randomly assigned to one of three groups (each n = 18): habitual toothbrushing/control, instruction/demonstration of toothbrushing, differential learning of toothbrushing. The differential learning approach comprised 15 different movement exercises (1/day), while instruction/demonstration of toothbrushing was based on repetitive practice of toothbrushing. Plaque (Turesky-modified Quigley-Hein plaque index (T-QHI)) and papilla bleeding (papilla bleeding index (PBI)) scores were assessed prior to the first toothbrushing (t0, baseline) and 21 (t1), 42 (t2) and 63 (t3) days after beginning of the study. Primary statistical analyses were performed with cumulative logit regression models with repeated measures. The global significance level was set to 5% two-sided. RESULTS: At all time points, PBI and T-QHI were significantly reduced by differential learning compared to instruction/demonstration of toothbrushing and habitual toothbrushing. Compared to baseline, differential learning improved PBI and T-QHI significantly at all time points. In the other groups, no significant reduction of PBI compared to baseline was observed. T-QHI was significantly reduced by habitual toothbrushing only at t1 and by instruction/demonstration of toothbrushing at t1 and t2. Differential learning had an improved effect on posterior compared to anterior teeth. CONCLUSION: Differential learning of toothbrushing improved plaque reduction and reduced gingival inflammation compared to habitual toothbrushing and instruction/demonstration of toothbrushing in 6- to 9-year-old children in mixed dentition. CLINICAL RELEVANCE: Toothbrushing skills of children might be improved by differential learning. TRIAL REGISTRATION: ISRCTN14951343, https://www.isrctn.com/ISRCTN14951343?

Impact of a Differential Learning Approach on Practical Exam Performance: A Controlled Study in a Preclinical Dental Course.

The aim of this study was to evaluate if differential learning in a preclinical dental course impacted the performance of dental students in a practical exam (preparation of a gold partial crown) immediately after the training session and 20 weeks later compared to conventional learning. This controlled study was performed in a preclinical course in operative dentistry at a dental school in Germany. Third-year students were trained in preparing gold partial crowns by using either the conventional learning (n=41) or the differential learning approach (n=32). The differential learning approach consisted of 20 movement exercises with a continuous change of movement execution during the learning session, while the conventional learning approach was mainly based on repetition, a methodological series of exercises, and correction of preparations during the training phase. Practical exams were performed immediately after the training session (T1) and 20 weeks later (T2, retention test). Preparations were rated by four independent and blinded examiners. At T1, no significant difference between the performance (exam passed) of the two groups was detected (conventional learning: 54.3%, differential learning: 68.0%). At T2, significantly more students passed the exam when trained by the differential learning approach (68.8%) than by the conventional learning approach (18.9%). Interrater reliability was moderate (Kappa: 0.57, T1) or substantial (Kappa: 0.67, T2), respectively. These results suggest that a differential learning approach can increase the manual skills of dental students.