The good toothbrushing game: a school-based dental hygiene program for increasing the toothbrushing effectiveness of children.
Turn tooth-brushing into a quick classroom contest and kids’ teeth stay cleaner for months.
01Research in Context
What this study did
Researchers turned tooth-brushing into a daily classroom game.
Three first-grade classes competed to see which team left the least pink plaque tablets on their teeth.
The game ran for weeks and the team with the cleanest teeth each day won a small prize.
What they found
Plaque scores dropped fast in every room.
The clean-teeth habit stuck—kids still brushed well nine months later.
How this fits with other research
McHugh et al. (2016) used the same group-contingency trick to cut disruptive behavior instead of plaque.
Both studies show that “our class vs. yours” games work fast in early elementary rooms.
Miak et al. (2024) later moved the idea to adults with disabilities.
They swapped the team contest for a self-checklist and still got better brushing.
Singh et al. (1982) looks like a clash—it used tooth-brushing as punishment to stop rumination.
The difference is purpose: here brushing is a fun skill, there it was an aversive consequence.
Why it matters
You can copy the game in any K-2 room tomorrow.
Pick a visible goal, post daily scores, and let the kids cheer each other on.
No extra staff, no cost, and the health benefit lasts the whole school year.
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Join Free →Hand out plaque tablets, split the class into two teams, and post the cleanest-teeth score at lunch.
02At a glance
03Original abstract
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.
Journal of applied behavior analysis, 1982 · doi:10.1901/jaba.1982.15-171