{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:40Z","timestamp":1787014360473,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Paed Dentistry"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Effective removal of dental plaque is essential factor for prevention of caries, gingival, and periodontal diseases in children and adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate factors associated with improving toothbrushing performance (TB\u2010P) among children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An observational cohort study analyzed all paediatric patients receiving regular examinations in a single dental clinic between 2009 and 2017 and regularly brushing their teeth with a triple\u2010headed toothbrush (TH\u2010TB). At every periodic follow\u2010up, the TB\u2010P of the child\/parent was evaluated using the TB\u2010P Skill Index (TB\u2010PS\u2010I); that is, did the child reach all five teeth segments within each arch and did he\/she perform 10 back\u2010and\u2010forth stocks in each segment. When not optimal, they received instructions for improving TB\u2010P and subsequently were asked to re\u2010demonstrate. TB\u2010PS\u2010I was calculated and analyzed for correlation with other explanatory variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1737 children with 7399 follow\u2010up appointments were analyzed. Older age, female gender, higher number of follow\u2010up appointments, and compliance with twice\u2010daily toothbrushing significantly improved TB\u2010P. The most typical mistakes in their performance were not reaching the canine segments and not performing enough strokes in each segment. Instructions given after imperfect TB\u2010P significantly improved the TB\u2010P. The magnitude of improvement, however, did not correlate with the performers' age, gender, or the number of follow\u2010up visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A significant percentage of children &gt;8\u2009years did not perform optimal toothbrushing even when using TH\u2010TB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ipd.13251","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T03:46:56Z","timestamp":1721792816000},"page":"405-413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors associated with toothbrushing performance among children: An observational cohort 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