The good toothbrushing game: a school-based dental hygiene program for increasing the toothbrushing effectiveness of children.

There has been a serious lack of experimentally verified, effective dental hygiene programs in the schools. In and of themselves, the instruction-alone programs which comprise children's dental education do not produce proper toothbrushing skills. In the present study, a school-based contingency dental hygiene program designed to increase the effectiveness of children's toothbrushing skills at home was implemented with grade one and two classes. Each class was divided into teams and participated in the "Good Toothbrushing Game." Each day four children fron each team had the cleanliness of their teeth assessed according to the Simplified Oral Hygiene Index (Greene & Vermillion, 1964). The team with the lowest mean oral hygiene score was declared the daily winner. Winning teams received stickers and had their names posted. A multiple baseline across classrooms single-subject group design. (Hersen & Barlow, 1976, pp. 228-229) established that the good toothbrushing game greatly increased the effectiveness of children's oral hygiene skills. the treatment terminal levels for the grade one scores was 2.0 as compared to a baseline terminal level of 5.0 and for the grade two's was 2.3 compared to 5.7 at the end of baseline. A 9-mo follow-up indicated that these results were maintained. The data strongly suggest that proper implementation of behavioral principles is essential to the success of oral hygiene programs.