Background: Disclosing agents have a long history of use as an aid in children’s tooth brushing instruction. However, their benefit when used to improve self-performed tooth brushing ability without any tooth brushing instruction has not been investigated.
Objective: To evaluate the effect of disclosed plaque visualization on improving the self-performed, tooth brushing ability of primary schoolchildren.
Material and Method: A cluster-randomized, crossover study was conducted in Nakhon Nayok province, Thailand. A total of 122 second-grade schoolchildren, aged 8-10 years old, from 12 schools were randomly divided into 2 groups. The first group was assigned to brush with disclosed plaque visualization, while the other group brushed without disclosed plaque visualization. One month later, the groups switched procedures. Tooth brushing ability was evaluated by the subjects’ reduction in patient hygiene performance (PHP) scores. The data were analyzed using repeated-measures analysis of variance, with significance set at p<0.05.
Results: Disclosed plaque visualization had a significant effect on improving the children’s self-performed, tooth brushing ability in all areas of the mouth (p<0.001), particularly for anterior teeth, mandibular teeth, buccal surfaces, and areas adjacent to the gingival margin (p<0.001).
Conclusion: Disclosed plaque visualization is a viable technique to improve children’s self-performed tooth brushing ability, and could be used in school-based oral health promotion programs.

Keywords: Disclosing agent, Plaque visualization, School-based tooth-brushing, Self-performed tooth brushing