Effectiveness of a toothbrushing intervention utilizing puzzle-solving game assisted with visual aids among adolescents: A single-blind randomized controlled trial.

Background: Maintaining good oral hygiene through effective toothbrushing is crucial for preventing dental issues in adolescents. Conventional oral health education (OHE) and video demonstration approach are passive means of OHE, that often fail to engage this age group. This study introduced an innovative approach to OHE by combining jigsaw puzzle and visual aids to improve oral health outcomes among adolescents.

Objective: To assess the effectiveness of Jigsaw Puzzle-assisted Visual Reinforcement (JPVR) technique on toothbrushing knowledge, practices, and clinical oral health parameters compared to conventional OHE and video demonstration among adolescents.

Material And Methods: This single-blind randomized controlled trial involved 195 adolescents aged 12-15 years randomly allocated to three groups: conventional OHE (control), video demonstration and JPVR. Interventions were administered, and assessments were carried out at baseline, 1 month, and 3 months. Prior to the start of the study, the oral hygiene aids used were standardized. Outcomes were measured using a self-designed, validated closed-ended questionnaire to assess the toothbrushing knowledge and practices. This was followed by clinical examination carried out using gingival and plaque indices by a blinded examiner.

Results: At baseline, groups had comparable knowledge, practices, and clinical parameters. At 3 months, the JPVR group demonstrated significantly higher knowledge, better practices, lower plaque, and reduced gingival scores compared to other groups.

Conclusions: The JPVR technique improved toothbrushing knowledge, practices, and clinical oral health parameters among adolescents. This approach fostered active learning and knowledge retention and is a cost-effective strategy for promoting positive oral health outcomes among children.