Oral hygiene instruction of adults by means of a self-instructional manual.

The need for improved oral cleanliness in adults presents a large scale resource requirement for professional manpower if oral hygiene instruction is to be accomplished conventionally on an individual basis at the chairside. Therefore a self-instructional manual in oral hygiene measures, to be used by the patients at home, has been designed. The effect on oral hygiene of periodontal patients following instruction by means of this manual has been compared with the effect of one instruction carried out by a dental hygienist as well as with the effect of minimal instruction by the aid of a short brochure. Thirty-seven patients (25--64 years of age) were allocated to three groups matched with regard to baseline scores of dento-gingival plaque, age and sex. Presence of disclosed dento-gingival plaque (Plak-lite) and gingival bleeding on probing were recorded at the start, 1, 2 and 6 weeks, 3 and 6 months. Toothbrushing performance of the patients was evaluated at each visit by a "brushing test". The treatment of all the patients consisted of scaling and polishing of the teeth at the start and after 3 months as well as the patients being supplied with the necessary oral hygiene aids including a lighted mouth mirror, a toothbrush, toothpicks and disclosing tablets. The baseline mean plaque and bleeding scores of 64 and 40% decreased during the first 6 weeks to a level of 20 and 14%. This improvement was maintained during the 6-month study period. Among the three groups no significant differences were observed in oral hygiene and gingival health. The results indicate that an oral hygiene instructional mode relatively independent of professional manpower may be equally effective as one single personal instruction. Furthermore the results suggest that factors other than the instruction per se are important for obtaining improvements in oral home care.