COMPARATIVE EFFECTIVENESS OF VERTICAL-HORIZONTAL VERSUS FONES-HORIZONTAL COMBINED TOOTHBRUSHING TECHNIQUES ON PLAQUE INDEX AMONG ELEMENTARY SCHOOL CHILDREN

Abstract

This study aims to determine and compare the effectiveness of the Vertical-Horizontal versus Fones-Horizontal combined toothbrushing techniques on the plaque index among elementary school children. A quasi-experimental study with a pre-test and post-test design was conducted involving 60 students aged 9 to 11 years at SD Negeri 13 Kubu Gulai Bancah, West Sumatra, Indonesia. The participants were randomly divided into two equal groups: Group A utilized the Vertical-Horizontal technique, while Group B used the Fones-Horizontal technique. Over a 14-day intervention period, both groups performed twice-daily supervised brushing. Plaque index scores were clinically evaluated before and after the intervention using disclosing agents and statistically analyzed using Paired and Independent t-tests. The results showed that both combined methods significantly decreased the mean plaque index (p < 0.001), indicating that structured mechanical disruption successfully clears dental biofilms. However, the Independent t-test applied to the post-test scores demonstrated a statistically significant difference between the two groups (p = 0.004), where the Fones-Horizontal technique achieved a notably lower plaque score (1.12) compared to the Vertical-Horizontal technique (1.32). This outcome is closely linked to childhood psychomotor development, as circular movements align more naturally with the gross hand coordination of school-aged children. It can be concluded that the Fones-Horizontal combined toothbrushing technique provides a more practical, developmentally appropriate, and clinically efficient approach. These findings suggest that school dental health programs (UKGS) should prioritize teaching this specific combination to maximize oral hygiene outcomes.