Improving toothbrushing behaviour in an institution for the disabled in Lisbon, Portugal

The oral health of disabled persons is strongly associated with oral hygiene practices. However, many difficulties limit them from removing dental biofilms (plaque). Purpose: This pilot study evaluates changes in toothbrushing capability among 135 disabled individuals enrolled in an institution for the disabled. Methods: Direct observation of toothbrushing behaviour of the disabled was used to recommend changes required in daily toothbrushing programme. The simplified Debris Index (DI-S) was used to compare plaque removal outcomes over a 3-month period. Results: At baseline, of the 135 participants, 114 completed a routine toothbrushing procedure and 10 (8.8%) of them brushed all tooth surfaces. At the end of the study, 52 (48.6%) brushed all tooth surfaces. The mean difference between the initial and final DI-S was 0.62 (P < 0.01). Conclusion: Toothbrushing was not a common procedure at this institution. This study shows that it is possible to implement daily oral hygiene maintenance in disabled individuals. Furthermore, most participants will adopt more efficient toothbrushing behaviour when monitored daily.