Arafa A, Sheiko O, Jameel A, Fansa H A
Department of Pediatric Dentistry and Dental Public Health, Faculty of Oral and Dental Medicine, Misr International University, 28 Cairo-El Ismailia Road, Cairo, Egypt.
MOH, Al-Baha, Saudi Arabia.
Eur Arch Paediatr Dent. 2025 Feb;26(1):191-199. doi: 10.1007/s40368-024-00965-9. Epub 2024 Nov 12.
To assess the impact of the picture exchange communication system (PECS) on oral hygiene motivation and practices in healthy children aged five to seven years.
A total of 160 healthy children aged five to seven years were included in this study. At the first visit, the participants' guardians were asked to answer a questionnaire focussing on the sociodemographic, and the oral hygiene habits of the participants. All participants received a clinical examination to assess their dental caries experience using the ICDAS score, gingival condition using the gingival index (GI), and the amount of accumulated dental plaque using the Turesky Modification of the Quigley-Hein Plaque Index (TQHI), followed by comprehensive explanation of the proper oral hygiene protocol. The participants were randomly divided into two equal groups; the PECS group and the control group. The participants were re-assessed after 6 months. The collected data were statistically analysed using the Statistical Package for Social Sciences (SPSS) software version 23 at a p-value ≤ 0.05.
By the end of the follow-up period, the PECS group reported significantly greater adherence to regular tooth brushing (p = 0.006) with a frequency higher than twice per day (p < 0.000) and no need for parental motivation (p < 0.001), and had significantly lower mean GI and TQHI scores (p < 0.000). Most of the participants' guardians reported that the PECS cards were useful for use and that they would continue to use them 66/76 (86%).
The PECS was found to be effective in motivating children to adhere to proper tooth-brushing practices, as reflected by improvements in their oral health status and gingival condition.
评估图片交换沟通系统（PECS）对5至7岁健康儿童口腔卫生动机和行为的影响。
本研究共纳入160名5至7岁的健康儿童。在首次就诊时，要求参与者的监护人回答一份问卷，重点关注社会人口统计学信息以及参与者的口腔卫生习惯。所有参与者均接受临床检查，使用国际龋病检测和评估系统（ICDAS）评分评估其龋齿经历，使用牙龈指数（GI）评估牙龈状况，使用Turesky对Quigley-Hein菌斑指数的改良版（TQHI）评估牙菌斑积聚量，随后对正确的口腔卫生方案进行全面解释。参与者被随机分为两组，每组人数相等：PECS组和对照组。6个月后对参与者进行重新评估。使用社会科学统计软件包（SPSS）23版对收集的数据进行统计学分析，p值≤0.05。
随访期结束时，PECS组报告称，每天刷牙频率高于两次（p<0.000）且无需父母督促（p<0.001）的情况下，坚持定期刷牙的情况显著更好（p=0.006），且平均GI和TQHI评分显著更低（p<0.000）。大多数参与者的监护人报告称，PECS卡片使用起来很有用，他们会继续使用（66/76，86%）。
PECS被发现能有效激励儿童坚持正确的刷牙行为，这体现在他们的口腔健康状况和牙龈状况得到改善。
