Effectiveness And Acceptance: Toothbrushing Tools For Learning Disabilities Education

This quasi-experimental study aimed to evaluate the effectiveness and acceptance of three toothbrushing educational tools (TETs) – manual demonstration (MD), video modelling (VM), and virtual reality (VR) – in teaching adults with learning disabilities (ALD) toothbrushing skills to enhance their oral hygiene and reduce caregiver dependency. Thirty-eight ALD participants (aged ≥18) were recruited through convenient sampling and divided into three groups: MD (n=13), VM (n=13), and VR (n=12). Each received a one-on-one session using the modified Bass technique, facilitated by their designated TET. Standardised toothbrushes and toothpaste were used throughout the study. Oral hygiene was assessed using Podshadley’s Patient Hygiene Performance Index (PHP) pre- and post-intervention, while acceptance was measured using the User Experience Questionnaire-Short version (UEQ-S). Ethical approval was granted by the Medical Ethics Committee, Faculty of Dentistry, Universiti Malaya (DFCD2319/0040(P)). Data were analysed using one-way ANOVA and paired samples t-tests. Despite no significant effectiveness differences among TETs (p=0.994), VM yielded the highest PHP improvement (2.369) versus VR (2.183) and MD (2.102). Acceptance of VM and VR (2.34) exceeded MD (1.61), though 25% of VR users reported motion sickness. Within the study's limitations, VM and VR demonstrated better user acceptance despite comparable efficacy to MD, suggesting their potential as preferable alternatives for educational interventions targeting ALD. Future research should explore these findings in larger, more diverse samples over extended periods to verify their long-term effectiveness and acceptance.