Intraoral Camera-Assisted Parent Training

Condition(s) studied

Investigational drug(s) / intervention(s)

Intraoral Camera-Assisted Oral Hygiene Education: Participants receive individualized oral hygiene education using an intraoral camera. Dental findings such as plaque, caries, and gingival inflammation are visualized in real time. Disclosing agents highlight plaque-covered areas, and brushing demonstrations are performed directly on the child's teeth using the Modified Stillman and cross-brushing techniques. Parents and children receive visual feedback to reinforce proper oral hygiene practices.

Standard Verbal Oral Hygiene Education: Participants receive standard verbal oral hygiene education using a brushing model. The Modified Stillman and cross-brushing techniques are demonstrated verbally and on the model. Oral hygiene principles, plaque control, and the importance of regular brushing are explained to both children and parents.

Intraoral Photography of Permanent First Molars: Occlusal surfaces of permanent first molars will be photographed using the EZCAM VATECH intraoral camera to document plaque accumulation. The photographs will be shown only to participants in the camera-assisted education group during oral hygiene instruction. These images will help them see plaque areas and understand correct brushing. The control group will receive only verbal education and will not view the photographs. All images will be stored securely and used only for evaluation in the study.

Turkish Version of the Oral Health Literacy Assessment Task for Pediatric Dentistry (TOHLAT-P): Parental oral health literacy, knowledge about preventive dental care, and their ability to help their child with oral hygiene will be measured using the Turkish version of the Oral Health Literacy Assessment Task for Pediatric Dentistry (TOHLAT-P). This tool evaluates parents' understanding and use of oral health information. Higher scores indicate better oral health literacy.

Parent and Child Satisfaction Survey: A structured questionnaire was given to children and parents in the intraoral camera education group. The aim was to evaluate their satisfaction with the education process. The questionnaire focused on the usability of the intraoral camera and how helpful it was during dental education.

Study summary

The aim of this randomized controlled trial is to test the null hypothesis that parent education using an intraoral camera has no effect on children's oral hygiene levels, parental oral health literacy, or plaque accumulation on first permanent molars compared with standard verbal education. 40 children aged 5-7 and their parents will be randomly assigned to two groups. The intervention group will receive real-time visualization of dental conditions and brushing techniques using an intraoral camera, while the control group will receive standard verbal education using a brushing model. Outcomes include children's plaque and gum health and ICDAS caries scores. Secondary outcomes include Occlusal Plaque Index (OPI) on first molars. Assessments will be conducted at baseline and 1-month follow-up. This study tests whether intraoral camera-assisted education leads to better oral hygiene outcomes in children, improves parents' oral health literacy, and reduces plaque accumulation on the first permanent molars compared to standard verbal education.

Eligibility

Primary outcome measure(s)

• Children's Plaque Index (PI) — Baseline
  Plaque levels on the mesial, distal, buccal, and lingual surfaces of all present teeth, excluding partially erupted teeth, were assessed using the Silness and Löe Plaque Index (scores 0-3). Plaque Index and Criteria: 0.Absence of microbial plaque 1. Thin film of microbial plaque along the free gingival margin 2. Moderate accumulation with plaque in the sulcus 3. Large amount of plaque in sulcus or pocket along the free gingival margin
• Children's Plaque Index (PI) — 1 month after intervention
  Plaque levels on the mesial, distal, buccal, and lingual surfaces of all present teeth, excluding partially erupted teeth, were assessed using the Silness and Löe Plaque Index (scores 0-3). Plaque Index and Criteria: 0\. Absence of microbial plaque 1. Thin film of microbial plaque along the free gingival margin 2. Moderate accumulation with plaque in the sulcus 3. Large amount of plaque in sulcus or pocket along the free gingival margin
• Children's Gingival Index (GI) — Baseline
  Gingival status was assessed on the mesial, distal, buccal, and lingual surfaces of all present teeth, excluding partially erupted teeth, using the Löe and Silness Gingival Index (0-3). Gingival Index (GI) and Criteria: 0\. Normal gingiva; no inflammation; no discoloration (erythema); no bleeding. 1. Mild inflammation; slight erythema; minimal superficial alterations; no bleeding. 2. Moderate inflammation; erythema; bleeding on probing. 3. Severe inflammation; severe erythema and swelling; tendency to spontaneous bleeding; possible ulceration.
• Children's Gingival Index (GI) — 1 month after intervention
  Gingival status was assessed on the mesial, distal, buccal, and lingual surfaces of all present teeth, excluding partially erupted teeth, using the Löe and Silness Gingival Index (0-3). Gingival Index (GI) and Criteria: 0\. Normal gingiva; no inflammation; no discoloration (erythema); no bleeding. 1. Mild inflammation; slight erythema; minimal superficial alterations; no bleeding. 2. Moderate inflammation; erythema; bleeding on probing. 3. Severe inflammation; severe erythema and swelling; tendency to spontaneous bleeding; possible ulceration.
• ICDAS Caries Score — Baseline
  Caries status of all present teeth, excluding partially erupted teeth, was recorded using the International Caries Detection and Assessment System (ICDAS). ICDAS Codes (International Caries Detection and Assessment System) 0\. Sound tooth surface 1. First visual change in enamel 2. Distinct visual change in enamel 3. Localized enamel breakdown due to caries with no visible dentin 4. Underlying dark shadow from dentin (with or without enamel breakdown) 5. Distinct cavity with visible dentin 6. Extensive distinct cavity with visible dentin
• ICDAS Caries Score — 1 month after intervention
  Caries status of all present teeth, excluding partially erupted teeth, was recorded using the International Caries Detection and Assessment System (ICDAS). ICDAS Codes (International Caries Detection and Assessment System) 0\. Sound tooth surface 1. First visual change in enamel 2. Distinct visual change in enamel 3. Localized enamel breakdown due to caries with no visible dentin 4. Underlying dark shadow from dentin (with or without enamel breakdown) 5. Distinct cavity with visible dentin 6. Extensive distinct cavity with visible dentin
• Parental Oral Health Literacy (TOHLAT-P) — Baseline
  Parents' oral health literacy, understanding of preventive care, and ability to support children's oral hygiene, assessed by TOHLAT-P. This questionnaire is used to assess parents' oral health knowledge. It measures three types of knowledge (factual, procedural, and conceptual) and includes cognitive process levels (remembering, understanding, and analyzing). The tool also uses literacy and numeracy skills. It has three sections. The maximum score for each section is 12, 26, and 14. The total score range is 0-52. Higher scores indicate higher oral health literacy.
• Parental Oral Health Literacy (TOHLAT-P) — 1 month after intervention
  Parents' oral health literacy, understanding of preventive care, and ability to support children's oral hygiene, assessed by TOHLAT-P. This questionnaire is used to assess parents' oral health knowledge. It measures three types of knowledge (factual, procedural, and conceptual) and includes cognitive process levels (remembering, understanding, and analyzing). The tool also uses literacy and numeracy skills. It has three sections. The maximum score for each section is 12, 26, and 14. The total score range is 0-52. Higher scores indicate higher oral health literacy.

Trial sites (1)

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