The effect of showing plaque photographs at a tooth brushing lesson to children

Inadequate oral hygiene in children and adults is a common phenomenon. The
resulting dental diseases like caries are a major problem. To prevent the above
problem teaching children on the importance of good oral health where the most
important aspect is the oral hygiene instruction has proven meaningful.
Quantitative light-induced fluorescence (QLF) is a method to show caries,
calculus and plaque in photographs taken with this fluorescence camera. With
this method, old plaque is visualized by its* red fluorescence. The hypothesis
is that the display of such fluorescence photographs has a positive effect on
motivating participants to improve their oral hygiene.

In this study we investigate whether the display of QLF photos can encourage
children to brush better. This effect of QLF photos we want to explore in
children attending groups 7 or 8 of primary schools, where a toothbrush lesson
of the *Keep your mouth healthy' project from the Ivory Cross is the basis. The
question of this study is, "Does showing an individual fluorescence photo of
one*s natural teeth have a positive impact in motivating participants to
improve" their oral hygiene?.

A randomized controlled trial (RCT) will be carried out linked to a 'Keep your
mouth healthy' lesson.
Study population: Children with an age of about 10-12 years in group 7-8 of
primary school.

One half of the children get to see their fluorescence photo created at the
first visit. The fluorescence photo will be discussed and an appropriate oral
hygiene advice linked to the photo will be given.
The other half of the children will see their normal photo (where plaque is not
visible to the layman), and receive general advice.
At the 2nd visit all the children get to see their fluorescence photograph and
get it explained, after which an oral hygiene advice linked to the photo will
be given.

All children fill out a short questionnaire (2-A4) at the start of the
toothbrush lesson and directly after to measure oral hygiene knowledge,
behavior, motivation and locus of controls.
The questionnaire will be repeated during the 2nd visit.

Participation means only a very small burden on participating children: making
and explaining the QLF photo takes up to one minute per child per visit (2
visits), next to the "Hou je mond gezond' lesson in the classroom wich is given
to all children. Completing the questionnaire takes less than 5 minutes at a
time. Given the nature of the study, we expect that all children benefit from
the brushing lesson. There are no risks associated with participation.