J Clin Periodontol. 1992 Aug; 19(7): 460-3.

Cleaning effectiveness of chewing sticks among Tanzanian schoolchildren.

van Palenstein Helderman WH, Munck L, Mushendwa S, Mrema FG.

Department of Preventive and Community Dentistry, University of Dar es Salaam, Tanzania.

The oral hygiene of habitual chewing stick and toothbrush users who participated in an oral health education (OHE) programme in schools was evaluated. The study comprised all chewing stick users (n = 45) in standard 4 in 8 randomly selected experimental schools and all chewing stick users (n = 17) in standard 4 in 4 randomly selected control schools. Each chewing stick user was randomly matched with a toothbrush user of the same sex, age and school. Their ages ranged from 10 to 13 years with a mean of 11.5 years. The children in standard 4 of the 8 experimental schools received OHE. Among many topics aiming to improve oral health of children, the practice of systematic brushing was taught. The children practised weekly brushing sessions in schools under the supervision of instructed teachers. At baseline, the chewing stick users exhibited statistically significant more plaque, but their gingival condition was comparable with their matched toothbrush counter-parts. After 3 months, the chewing stick and the toothbrush users in the experimental schools, had reduced their plaque and gingival bleeding scores significantly to the same extent, whereas no substantial changes in oral hygiene occurred in the control group. The findings show that schoolchildren who participated in a school programme that emphasizes effective toothbrushing were able to improve their oral hygiene regardless of whether they were habitual chewing stick or toothbrush users.