Comparison of caregiver-performed toothbrushing with triple- and single-headed toothbrushes in preschool children with developmental disabilities: a randomized crossover study.

PURPOSE: To evaluate the plaque removal efficacy of a triple-headed versus a single-headed toothbrushes in preschool children with developmental disabilities (DD) through caregiver-performed toothbrushing, and to assess caregiver satisfaction with the triple-headed toothbrush. METHODS: This single-blind randomized crossover study included 24 pairs of preschool children aged 4-6 years with DD and their caregivers. Demographic characteristics, prebrushing plaque index, and decayed, missing, and filled primary teeth (dmft) scores were collected. Caregivers received toothbrushing instruction via a video clip according to the randomly assigned toothbrush sequence. They were then asked to brush their child's teeth, after which the immediate post-brushing plaque index and toothbrushing duration were recorded. Following a 4-week washout period, participants crossed over to the alternate toothbrush, and all procedures were repeated. At the end of the study, caregivers completed a satisfaction questionnaire regarding the triple-headed toothbrush. Demographic data were compared using Fisher's exact test. Paired t tests were used to compare outcomes between toothbrush types. Statistical significance was set at P < 0.05. RESULTS: The triple-headed toothbrush achieved significantly greater plaque reduction than the single-headed toothbrush, particularly on the palatal surfaces of the upper anterior and posterior teeth and the lingual surfaces of the lower posterior teeth (P < 0.05). Brushing time was also significantly shorter with the triple-headed toothbrush. Most caregivers reported high satisfaction with the triple-headed toothbrush, although a few expressed concerns regarding the brush head size and bristle softness. CONCLUSION: The triple-headed toothbrush showed superior plaque removal efficacy and reduced brushing time compared to the single-headed toothbrush in preschool children with DD. Caregivers also reported positive experiences using the triple-headed toothbrush. Therefore, it may be an effective oral hygiene aid for improving plaque control in this population.