Effect of Customized Oral Health Awareness Program on Knowledge and Practice of Oral Hygiene Maintenance Among Institutionalized Visually Impaired Individuals of Lucknow: A Cluster Randomized Study.

BACKGROUND

Visually impaired individuals face significant challenges in maintaining oral hygiene due to reliance on visual cues. Conventional oral health education (OHE) often fails to address their needs, leading to disparities in oral health outcomes. The aim of this study was to assess and compare the effectiveness of three customized oral health education strategies-Audio only (Group 1), Audio + Braille (Group 2), and Audio + Tactile Model (Group 3)-on oral health Knowledge, Attitude, Practice (KAP), and clinical oral hygiene status among institutionalized visually impaired individuals in Lucknow, India.

METHODS

A prospective cluster randomized controlled trial was conducted across two institutions, enrolling 180 visually impaired individuals aged ≥ 7 years. Of these, 15 were excluded based on eligibility criteria. The remaining 165 participants were randomly allocated into three intervention groups (55 participants per group). During follow-up, 5 participants from each group were lost, resulting in a final analysis of 150 participants (n = 50 per group). Each group received structured OHE via a designated modality, reinforced at 30, 60, and 90 days. Pre- and post-intervention assessments included Knowledge, Attitude, and Practice (KAP) scores and clinical parameters-Debris Index (OHI-S) and Gingival Index (GI). Data were analyzed using repeated measures ANOVA, Tukey's HSD, paired t-tests, one-way ANOVA, Chi-square tests, and Pearson's correlation.

RESULTS

All groups showed significant improvement post-intervention (p < 0.001), with the Audio + Braille group achieving the greatest gains in knowledge (26%-100%), attitude/practice (36.5%-68.4%), and clinical outcomes (Debris Index: 2.23 to 0.43; GI: 1.09 to 0.22). Repeated measures ANOVA and post hoc analysis confirmed Group 2's superiority across all parameters. Strong inverse correlations between behavior scores and clinical indices emerged over time (r > -0.85), highlighting the impact of behavior change on oral health.

CONCLUSION

Multisensory OHE strategies, especially Audio + Braille, were most effective in improving oral health knowledge and hygiene status. Integration of such sensory-adapted educational models into public health programs may enhance oral health equity among visually impaired populations.

TRIAL REGISTRATION: CTRI/2024/10/093533.