{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:51:06Z","timestamp":1791312666742,"version":"4.3.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Children with sensory disabilities exhibit a poor oral hygiene and a high prevalence of gingivitis and dental caries. Tailored multisensory oral health education interventions may improve tooth brushing skills and oral health. To develop and validate a multisensory game-based educational intervention to teach tooth brushing to children with visual and hearing impairments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>A developmental research design was used. A prototype was developed after literature review and expert interviews. This was validated by dentists and special educators and field tested among 15 children with visual impairment and 15 with hearing impairment with 7 play sessions over 4 weeks. Comprehensibility and acceptability were assessed through structured feedback, and effectiveness was measured by evaluating tooth brushing skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Experts agreed with the relevance, sequential accuracy of the brushing technique, and clarity of the game (Item-level Content Validity Index (I-CVI) and k* =1.00), confirming excellent content validity. Dentists suggested minor modifications regarding sequencing flexibility and a special educator suggested audio\/light cues. Children with visual impairment rated the game and the tooth brushing technique as easy to understand and the components easy to handle (I-CVI = 1.00), enjoyable (I-CVI = 0.93), and some suggested larger models. Children with hearing impairment showed perfect agreement across all aspects of the game. The children showed improvements in their tooth brushing skills (W = 0.00,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>The developed game-based educational intervention demonstrates strong validity and acceptability for oral hygiene education among children with sensory impairments. These findings support further evaluation of long-term effectiveness and application in oral health promotion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_346_26","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:02:32Z","timestamp":1788184952000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Design and validation of a multisensory game-based tooth brushing education tool for children with visual and hearing impairment"],"prefix":"10.4103","volume":"15","author":[{"given":"H Esther","family":"Nalini","sequence":"first","affiliation":[{"name":"Department of Public Health Dentistry, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India"},{"name":"Department of Periodontics, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, 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