Impact of sustained attention and working memory on toothbrushing efficacy in typically developing children: A cross-sectional study

Background: Toothbrushing in children depends on factors such as toothbrushing duration, frequency, technique, manual dexterity, and cognitive skills. Higher level of cognitive functions, known as executive functions, is required for effective toothbrushing. These include sustained attention and working memory. Poor oral hygiene and higher prevalence of dental caries are seen in children with neurodevelopmental disorders due to impairment of cognitive skills. Aim: The study aimed to assess the impact of sustained attention and working memory on toothbrushing efficacy in 9–12-year-old typically developing children. Methodology: A cross-sectional study included 120 typically developing children aged 9–12 years. Oral health status was recorded using the Decayed, Missing, and Filled Teeth index. The sustained attention and working memory were evaluated using d2 test and Corsi block tapping test, respectively. Toothbrushing efficacy was determined by using Turesky modification of Quigley-Hein Plaque Index – difference in mean scores from before and after toothbrushing. Data were analyzed using SPSS version 26, and P < 0.05 was considered as statistically significant. Results: The sustained attention, working memory, and toothbrushing efficacy increased significantly with age, and an association of sustained attention and working memory was seen with toothbrushing efficacy, irrespective of the child’s age, which was reported using Spearman’s coefficient ( P = 0.000). Conclusion: Both sustained attention and working memory significantly increased with age, and were significantly associated with higher toothbrushing efficacy in typically developing children.