Mechanical removal of plaque and biofilm is necessary to prevent oral diseases such as dental decay and periodontal disease. Patient’s ability to perform tasks is essential in the proper plaque control. A recent study published in 2019 in the British Dental Journal aimed to “evaluate dexterity and the effect it has on plaque control.”1
A total of 80 participants were selected to participate in this study (40 men and 40 women), age ranging from 18-60 years. Dexterity tests were conducted by having participants pick up peas with chopsticks and move them from one box to another. After dexterity was established, plaque scores were assessed using O’Leary score index. Finally oral hygiene instructions were given. The participants were then asked to brush and floss for 10 minutes after which their plaque score using the O’Leary score index was recorded.
The results showed older individuals had a lower dexterity score while younger participants scored higher. Those with a higher dexterity score showed the most improvement in plaque score after oral hygiene instructions were given. Additionally, the positive correlation was statistically significant for right-handed participants, but not for left-handed participants, the positive correlation was also more significant in men than in women.
This study shows that compliance and dexterity are very important in proper plaque management. Dexterity is important for holding a toothbrush properly, controlling pressure applied during brushing, movement of the toothbrush, speed of brushing, and reaching difficult to access areas while brushing among other things. If patients present with poor oral hygiene assessing dexterity should be included in their visit, if dexterity is determined to be an issue alternatives such as electric toothbrush and/or other modalities should be recommended to improve plaque control.
The authors conclude by stating, “Dexterity was the only significant predictor of improvement in oral hygiene. The age of the patient showed correlation, but it was not a significant predictor of improvement in oral hygiene. Dexterity of the patient can be measured using the simple chopstick test, as described in this study, in the patient’s initial assessment, even though they are non-habitual users of chopsticks.”
When assessing plaque control do you consider the patient’s dexterity? Would you consider using the chopstick test to better assess dexterity of patients struggling to manage plaque? Do you recommend electric toothbrushes to patients that may have limited dexterity?
- Barouch K, Al Asaad N, Alhareky M. Clinical relevance of dexterity in oral hygiene. Br Dent J. 2019;226(5):354-357. doi:10.1038/s41415-019-0040-1