Effectiveness of Triple-Headed Versus Conventional Single-Headed Toothbrushes on Gingival Health and Plaque Control Among Children and Adolescents With Visual Impairment: A Randomized Controlled Trial.

BACKGROUND

Children with visual impairment face oral hygiene challenges, relying on tactile cues rather than visual feedback. Conventional toothbrushes create barriers to adequate plaque control, while triple-headed toothbrushes offer simultaneous multi-surface cleaning through tactile positioning. This study aimed to compare the effectiveness of triple-headed toothbrushes versus conventional toothbrushes in reducing plaque and gingival scores among children and adolescents with visual impairment.

METHODS

This single-centre, single-blind, randomized controlled trial enrolled 108 children and adolescents (mean age 12.17 ± 3.48 years) with visual impairment in Belagavi, Karnataka, India. Participants were randomly allocated to triple-headed toothbrush or conventional single-headed toothbrush groups (54 each). All received structured oral health education and brushed twice daily under caregiver supervision for 3 months. Gingival score and plaque score were assessed using the Loe and Silness Gingival Index and the Silness and Loe Plaque Index at baseline and post-intervention. The triple-headed toothbrush acceptability was evaluated through structured questionnaires at the first week and 3 months.

RESULTS

Both groups demonstrated statistically significant reductions in gingival and plaque scores compared to baseline (p < 0.05). The triple-headed toothbrush group demonstrated a greater improvement in gingival health compared to the conventional toothbrush group. Post-intervention gingival scores were significantly lower in the triple-headed toothbrush group than in the conventional toothbrush group (p = 0.009). Plaque reduction was also greater in the test group (p < 0.001). Acceptability of the triple-headed toothbrush increased significantly over 3 months (p < 0.001). No adverse events were recorded.

CONCLUSION

The triple-headed toothbrush demonstrated superior effectiveness in both plaque reduction and gingival health improvement compared to the conventional toothbrush in children and adolescents with visual impairment. The intervention showed high user acceptability and safety, offering a promising oral hygiene solution for this vulnerable population.

TRIAL REGISTRATION: CTRI/2025/03/082795 (registered 19/03/2025).