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«∑π— μ®Ãÿ “œ2554;34:193-202
CU Dent J. 2011;34:193-202

∫ ∑ «‘ ∑ ¬ “ ° “ √

Original Article

°“√‡ª√¬’ ∫‡∑¬’ ∫ª√– ∑‘ ∏º‘ ≈¢Õß°“√„™·â ª√ß ø’ πí

‰øø“Ñ °∫— ·ª√ß ø’ πí ∏√√¡¥“μÕà °“√≈¥°“√‡°¥‘ ‡ÀßÕ◊ °

Õ°— ‡ ∫·≈–°”®¥— §√“∫®≈ÿ π‘ ∑√¬’ „å π‡¥°Á Õ“¬ÿ7-10ªï

Õ√Õÿ¡“ Õß— «√“«ß»å ∑.∫., «∑.¡ (∑π— μ°√√¡ ”À√∫— ‡¥°Á ) Õ.∑. (∑π— μ°√√¡ ”À√∫— ‡¥°Á )1
«√“π™ÿ ªμî æ‘ ≤— πå ∑.∫., M.P.H.M., M.S. (Epidemiology), S.D. (Epidemiology), Õ.∑. (∑π— μ “∏“√≥ ¢ÿ )2
¡π — π—π∑å μ—ßÈ «ß»å∂“«√°®‘ ∑.∫.3
«∑‘ «—≤πå √“™§√ÿ± ∑.∫.4

1¿“§«‘™“∑—πμ°√√¡ ”À√∫— ‡¥°Á §≥–∑—πμ·æ∑¬»“ μ√å ¡À“«∑‘ ¬“≈—¬¢Õπ·°πà ®.¢Õπ·°àπ
2¿“§«‘™“∑π— μ°√√¡™ÿ¡™π §≥–∑—πμ·æ∑¬»“ μ√å ¡À“«‘∑¬“≈¬— ¢Õπ·°àπ ®.¢Õπ·°πà
3‚√ß欓∫“≈ÀπÕß·´ß Õ.ÀπÕß·´ß ®. √–∫√ÿ ’
4‚√ß欓∫“≈‡´°“ Õ.‡´°“ ®.ÀπÕߧ“¬

∫∑§—¥¬Õà

«—μ∂ÿª√– ß§å ‡æ◊ËÕ‡ª√’¬∫‡∑’¬∫ª√– ‘∑∏‘º≈¢Õß°“√„™â·ª√ß ’øíπ‰øøÑ“°—∫·ª√ß ’øíπ∏√√¡¥“„π°“√≈¥°“√‡°‘¥
‡ÀßÕ◊ °Õ—°‡ ∫·≈–°”®—¥§√“∫®ÿ≈‘π∑√¬’ „å π™à«ß√–¬–‡«≈“ 3 ‡¥◊Õπ

«— ¥ÿ·≈–«‘∏’°“√ ∑”°“√»÷°…“‡ª√¬’ ∫‡∑¬’ ∫°≈¡ÿà §«∫§ÿ¡·∫∫ ÿà¡„π‡¥Á°π°— ‡√’¬πª√–∂¡»°÷ …“ Õ“¬ÿ√–À«à“ß 7-10 ªï
®”π«π 70 §π ·∫ßà ‡¥Á°ÕÕ°‡ªìπ 2 °≈¡ÿà §Õ◊ °≈¡àÿ ∑¥≈Õß·≈–°≈ÿ¡à §«∫§¡ÿ °≈àÿ¡≈–‡∑à“Ê °π— ‚¥¬°“√ ¡àÿ ·∫∫·∫ßà
™È—πμ“¡√–¥—∫™—Èπ‡√’¬π·≈–‡æ» °”Àπ¥„À⇥Á°„π°≈ÿà¡∑¥≈Õß„™â·ª√ß ’øíπ‰øøÑ“™π‘¥°“√‡§≈◊ËÕπ∑Ë’·∫∫ Ë—π·≈–À¡ÿπ
·≈–°≈¡ÿà §«∫§¡ÿ „™·â ª√ß ø’ πí ∏√√¡¥“ «¥— ¥™— π‡’ ÀßÕ◊ °Õ°— ‡ ∫¢Õß Löe ·≈– Silness ·≈–¥™— π§’ √“∫®≈ÿ π‘ ∑√¬’ æå ‡’ Õ™æ’
¢Õß Podshadley ·≈– Haley ∑’ˇ√Ë‘¡μâπ»÷°…“·≈–«—¥´”È ∑ÿ°‡¥◊Õπ‡ªìπ√–¬–‡«≈“ 3 ‡¥◊Õπ ∑¥ Õ∫§«“¡·μ°μà“ß
¢Õß§à“‡©≈’ˬ√–À«à“ß°≈àÿ¡∑¥≈Õß·≈–°≈ÿࡧ«∫§ÿ¡ ‚¥¬„™â ∂‘μ‘°“√«‘‡§√“–À姫“¡·ª√ª√«π‡¡◊ËÕ¡’°“√«—¥´”È ∑Ë’√–¥—∫
π¬—  ”§—≠ 0.05

º≈°“√»°÷ …“ ‡¡◊ËÕ‡«≈“ 3 ‡¥◊Õπæ∫«à“ §à“‡©≈Ë’¬°“√≈¥≈ߢÕߥ—™π’‡Àß◊Õ°Õ—°‡ ∫®“°§à“æÈ◊π∞“π√–À«à“ß°≈àÿ¡
∑¥≈Õß°—∫°≈¡àÿ §«∫§ÿ¡‰¡¡à §’ «“¡·μ°μà“ßÕ¬“à ß¡’π¬—  ”§≠— ∑“ß ∂μ‘ ‘ (p = 0.19)  ”À√—∫§à“‡©≈’ˬ°“√≈¥≈ߢÕߥ—™π’
§√“∫®ÿ≈‘π∑√’¬å®“°§à“æ◊Èπ∞“π√–À«à“ß°≈àÿ¡∑¥≈Õß°—∫°≈àÿ¡§«∫§ÿ¡æ∫«à“ ‰¡à¡’§«“¡·μ°μà“ß°—πÕ¬à“ß¡’π—¬ ”§—≠
∑“ß ∂‘μ‘ (p = 0.73) ‡™àπ‡¥’¬«°π—

 √ªÿ ª√– ‘∑∏‘º≈„π°“√≈¥°“√‡°‘¥‡Àß◊Õ°Õ—°‡ ∫·≈–°”®—¥§√“∫®ÿ≈‘π∑√’¬å¢Õß°“√„™â·ª√ß ’øíπ‰øøÑ“‰¡à·μ°μà“ß
®“°·ª√ß ’øπí ∏√√¡¥“∑™’Ë «à ߇«≈“ 3 ‡¥Õ◊ π

(« ∑π— μ ®ÿÓœ 2554;34:193-202)

§” ”§—≠: §√“∫®≈ÿ ‘π∑√¬’ ;å ·ª√ß ø’ πí ‰øøÑ“; ‡ÀßÕ◊ °Õ—°‡ ∫

194 Angwaravong O, et al CU Dent J. 2011;34:193-202

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« ∑π— μ ®Ãÿ “œ 2554;34:193-202 Õ√Õ¡ÿ “ Õ—ß«√“«ß»å ·≈–§≥– 195

« — ¥ÿ·≈–«∏‘ °’ “√ §√“∫®ÿ≈π‘ ∑√’¬·å ≈–«—¥§“à ¥—™π’§√“∫®≈ÿ π‘ ∑√¬’ å懒 Õ™æ’ (Patient
Hygiene Performance, PHP) ¢Õß Podshadley ·≈– Haley
°“√»÷°…“πÈ’‡ªìπ°“√∑¥≈Õ߇ª√’¬∫‡∑’¬∫°≈àÿ¡§«∫§ÿ¡ (Õâ“ß∂÷ß„π Blount ·≈– Strokes19) °“√∫—π∑÷°§à“º≈
·∫∫ ¡àÿ (randomized controlled trial) ·∫∫ª°ª¥î ∑“߇¥¬’ « °“√μ√«®„π§√ßÈ— π‡’È ªπì §“à ¥™— π‡’ ÀßÕ◊ °Õ°— ‡ ∫æπ◊È ∞“π(GI0) ·≈–
(single blinded) „π‡¥Á°π—°‡√’¬π™—Èπª√–∂¡»÷°…“ªï∑’Ë 1-3 §à“¥—™π’§√“∫®ÿ≈‘π∑√’¬åæÈ◊π∞“π (PI0) √«¡∑—È߇¥Á°π—°‡√’¬π„π
Õ“¬√ÿ –À«“à ß 7-10 ªï ®“°‚√߇√¬’ π “∏μ‘ ¡À“«∑‘ ¬“≈¬— ¢Õπ·°πà ·μ≈à –°≈¡ÿà ®–‰¥√â ∫— ·®°·ª√ß ø’ πí ·≈–¬“ ø’ πí ∑ßÈ— ‡¥°Á π°— ‡√¬’ π
Õ”‡¿Õ‡¡◊Õß ®—ßÀ«—¥¢Õπ·°àπ ‚¥¬„™â«‘∏’°“√ àÿ¡·∫∫·∫àߙȗπ ·≈–ºŸâª°§√Õ߉¥â√—∫§”Õ∏‘∫“¬«‘∏’°“√·ª√ßøíπ∑’Ë∂Ÿ°μâÕß∑È—ß
(stratified randomization) μ“¡√–¥—∫™È—π‡√’¬π ·≈–‡æ» ·ª√ß ’øíπ‰øøÑ“·≈–·ª√ß ’øíπ∏√√¡¥“‚¥¬«‘∏’°“√ “∏‘μ·≈–
·∫ßà π°— ‡√¬’ π‡ªπì 2 °≈¡àÿ °≈¡àÿ ·√°‡ªπì °≈¡ÿà ∑¥≈Õß®–·ª√ßøπí Ω°ñ ªØ∫‘ μ— ‘ ·≈–‰¥√â ∫— §”·π–π”„π°“√®¥∫π— ∑°÷ ª√–®”«π— „π°“√
¥â«¬·ª√ß ’øíπ‰øøÑ“¬’ËÀâÕ§Õ≈‡°μ √àÿπ·∫μ‡μÕ√’Ë‚¡™—Ëπ ·ª√ßøíπ μàÕ®“°π—Èπ„À⇥Á°·ª√ßøíπ‚¥¬„™â·ª√ß ’øíπ∑Ë’
§¥‘  å ≈Õππ∑Ë’ πŸ  å (Colgate® Battery Motion Kids Looney °”Àπ¥„Àâ«—π≈– 2 §√È—ß §√È—ß≈– 2 π“∑’‡ªìπ‡«≈“ 1 ‡¥◊Õπ
Tunes) (∫√…‘ ∑— §Õ≈‡°μ-ª“≈¡å ‚Õ≈ø’ ®”°¥— ª√–‡∑»‰∑¬) ‚¥¬ ·≈â«°≈—∫¡“μ√«®§à“¥—™π’‡Àß◊Õ°Õ—°‡ ∫·≈–§à“¥—™π’§√“∫
ª≈“¬¢π·ª√ß®–¡¢’ π·ª√ß 2 °≈¡ÿà ∑ª’Ë ≈“¬ ¥ÿ ®–‡ªπì °≈¡àÿ ¢π ®ÿ≈‘π∑√’¬å ∫—π∑÷°º≈§à“¥—™π’‡Àß◊Õ°Õ—°‡ ∫∑’ˇ¥◊Õπ∑Ë’ 1 (GI1)
·ª√ß∑Ë’¡’≈—°…≥–‡ªìπ«ß°≈¡·≈–Õ’°°≈ÿà¡®–¡’¢π·ª√ßÕ’° 11 ·≈–§“à ¥—™π§’ √“∫®ÿ≈‘π∑√¬’ ∑å ˇ’ ¥Õ◊ π∑Ë’ 1 (PI1) ∑”°“√μ√«®«¥—
°√–®ÿ°‡√’¬ß∂—¥¡“ ´Ë÷ß¡’°“√∑”ß“π·∫∫ Ë—π·≈–À¡ÿπ °≈ÿà¡∑’Ë §“à ¥™— π‡’ ÀßÕ◊ °Õ°— ‡ ∫·≈–§“à ¥™— π§’ √“∫®≈ÿ π‘ ∑√¬’ å ´È”∑°ÿ 1 ‡¥Õ◊ π
 Õ߇ªìπ°≈àÿ¡§«∫§ÿ¡®–„™â·ª√ß ’øíπ∏√√¡¥“¬’ËÀâÕ§Õ≈‡°μ Õ’° 2 §√ß—È ‡ªπì §à“¥™— π’‡Àß◊Õ°Õ—°‡ ∫∑ˇ’ ¥Õ◊ π∑’Ë 2 (GI2) ·≈–
‡¥Õ≈°ÿ ´å (Colgate® Deluxe) (∫√…‘ —∑§Õ≈‡°μ-ª“≈å¡‚Õ≈ø’ ‡¥◊Õπ∑’Ë 3 (GI3) ·≈–§à“¥™— π’§√“∫®ÿ≈‘π∑√’¬∑å ’Ë‡¥Õ◊ π∑’Ë 2 (PI2)
®”°¥— ª√–‡∑»‰∑¬) ´Ë÷ß¡¥’ “â ¡·ª√ßμ√߬“« 16 ‡´π쑇¡μ√ ¡’ ·≈–‡¥◊Õπ∑’Ë 3 (PI3) π”§à“∑’ˉ¥â‰ª∑¥ Õ∫·≈–«‘‡§√“–Àå∑“ß
¢π·ª√ß 4 ·∂« ·≈–™π¥‘ ¢π·ª√ßπ¡ÿà  ∂‘쑇æË◊Õ‡ª√’¬∫‡∑’¬∫§«“¡·μ°μà“ß√–À«à“ß 2 °≈àÿ¡∑¥≈Õß
„π·μ≈à –™«à ߇«≈“
‡¥Á°π—°‡√’¬π∑’ˇ¢â“√à«¡„π°“√»÷°…“¡’‡°≥±å°“√§—¥‡¢â“
(inclusion criteria) §◊Õ ‡ªìπºŸâ∑’ˉ¡à¡’‚√§ª√–®”μ—« À√◊Õ °“√μ√«® Õ∫§«“¡‡∑Ë’¬ßμ√ߢÕߺŸâμ√«® ‡πË◊Õß®“°¡’
‚√§∑“ß√–∫∫ ‰¡Õà ¬„àŸ π™«à ß°“√√°— …“‚√§¡–‡√Áß À√◊Õ‚√§≈¡™—° ºŸâμ√«®¥—™π’§√“∫®ÿ≈‘π∑√’¬å·≈–¥—™π’‡Àß◊Õ°Õ—°‡ ∫„π°“√
‰¡à„™â·ª√ß ’øíπ‰øøÑ“Õ¬àŸ‡ªìπª√–®”  “¡“√∂·ª√ßøíπ¥â«¬ »÷°…“§√—Èßπ’È‡æ’¬ß 1 §π ·≈–ºŸâμ√«®®–∂Ÿ°ª°ªî¥ (single-
μπ‡Õ߉¥â‡ªìπª√–®”∑ÿ°«—π ·≈–‰¡à„ àÕÿª°√≥å∑“ß∑—πμ°√√¡ blinding) ®÷߉¡à∑√“∫«à“°”≈—ßμ√«®‡¥Á°π—°‡√’¬π∑Ë’‡ªìπ°≈ÿà¡
®—¥øíπ„π™àÕߪ“°∑’Ë¢“°√√‰°√∫πÀ√◊Õ¢“°√√‰°√≈à“ß„π™à«ß ∑Ë’„™â·ª√ß ’øíπ™π‘¥„¥ °“√«—¥§«“¡‡∑Ë’¬ßμ√ߢÕß°“√μ√«®∑”
∑Ë’∑”°“√»÷°…“ ‚¥¬°“√ ÿࡇ¥Á°π—°‡√’¬π¡“μ√«®´”È √âÕ¬≈– 10 ¢Õß°“√μ√«®
„π·μà≈–§√—Èß ®“°πÈ—π𔉪∑¥ Õ∫§à“‡∑’ˬßμ√ߢÕߺŸâμ√«®
°“√§”π«≥¢π“¥μ—«Õ¬à“ß‚¥¬°”Àπ¥§à“Õ—≈ø“ (α) (intra-examiner reliability) ‚¥¬„™â ∂‘μ‘ —¡ª√– ‘∑∏Ï‘
‡∑à“°—∫ 0.05 §à“‡∫μâ“ (β) ‡∑à“°—∫ 0.20 À√◊ÕÕ”π“®°“√  À —¡æ—π∏å¿“¬„π™Èπ— (intraclass correlation coefficient)
∑¥ Õ∫√Õâ ¬≈– 80 ‚¥¬Õ“»¬— §“à  ∂μ‘ ‘ ( «à π‡∫¬’Ë ß‡∫π¡“μ√∞“π) æ∫§“à §«“¡‡∑¬’Ë ßμ√ߢÕß°“√«¥— §“à ¥™— π§’ √“∫®≈ÿ π‘ ∑√¬’ ‡å ªπì 0.95
®“°°“√»÷°…“¢Õß Yankell ·≈– Emling7 ¡“·∑π§à“„π
 Ÿμ√§”π«≥¢π“¥μ—«Õ¬à“ß ‚¥¬¢π“¥μ—«Õ¬à“ß∑’ˉ¥â‡∑à“°—∫ °“√«‘‡§√“–À¢å Õâ ¡Ÿ≈
35 §π
À≈—ß®“°‡°Á∫√«∫√«¡¢âÕ¡Ÿ≈‰¥â𔉪«‘‡§√“–Àå¢âÕ¡Ÿ≈∑“ß
ß“π«‘®—¬πÈ’‰¥âºà“π°“√æ‘®“√≥“¢Õߧ≥–°√√¡°“√  ∂‘μ‘‚¥¬„™â ∂‘μ‘·∫∫æ√√≥π“ ‰¥â·°à °“√«‘‡§√“–Àå√âÕ¬≈–
®√‘¬∏√√¡°“√«‘®—¬„π¡πÿ…¬å ¡À“«‘∑¬“≈—¬¢Õπ·°àπ (‡≈¢∑Ë’ §à“‡©≈’ˬ ·≈–§à“‡∫’ˬ߇∫π¡“μ√∞“𠇪√’¬∫‡∑’¬∫§«“¡
HE 481201) ·≈–‰¥â√—∫§«“¡¬‘π¬Õ¡‡ªìπ≈“¬≈—°…≥åÕ—°…√ ·μ°μ“à ߢÕߢÕâ ¡≈Ÿ √–À«“à ß°≈¡àÿ »°÷ …“‚¥¬„™ â ∂μ‘ ∑‘ ¥ Õ∫∑‡’ ∑ μå
®“°‡¥Á°π—°‡√’¬π·≈–ºâŸª°§√Õß°àÕπ‡¢â“√à«¡°“√»÷°…“ ‡¥Á° (t-test) „π°√≥’∑’ˇªìπ¢âÕ¡Ÿ≈μàÕ‡π◊ËÕß ·≈–∑¥ Õ∫‰§ ·§«√å
π°— ‡√¬’ π‰¥√â ∫— °“√°”®¥— Àπ‘ πÈ”≈“¬·≈–§√“∫®≈ÿ π‘ ∑√¬’ ‚å ¥¬°“√¢¥Ÿ (chi-square test) „π°√≥∑’ ’ˇªìπ¢âÕ¡≈Ÿ °≈¡àÿ §”π«≥§à“°“√
À‘πªŸπ·≈–¢¥— øπí ∑ȗߪ“° À≈—ß®“°π—πÈ 1 ‡¥Õ◊ 𠇥Á°π°— ‡√¬’ π ≈¥≈ߢÕߥ—™π’‡Àß◊Õ°Õ—°‡ ∫„π·μà≈–‡¥◊Õπ®“°§à“æ◊Èπ∞“π
‰¥â√∫— °“√μ√«®§à“¥™— π‡’ ÀßÕ◊ °Õ—°‡ ∫ (Gingival Index, GI)
¢Õß Löe ·≈– Silness18 ºŸâμ√«®®–„™â ¬’ Õâ ¡Õ√‘ ‘‚∑√´π‘ ¬âÕ¡

196 Angwaravong O, et al CU Dent J. 2011;34:193-202

„π‡¥Õ◊ π∑Ë’ 1 (GI0-GI1) ‡¥◊Õπ∑Ë’ 2 (GI0-GI2) ·≈–‡¥Õ◊ π∑Ë’ °≈ÿà¡∑¥≈Õß (°≈àÿ¡·ª√ß ’øíπ‰øøÑ“) ®”π«π 35 §π ·≈–
3 (GI0-GI3) ·≈–§”π«≥§“à °“√≈¥≈ߢÕߥ™— π§’ √“∫®≈ÿ π‘ ∑√¬’ å °≈ÿ¡à §«∫§¡ÿ (°≈ÿ¡à ·ª√ß ’øíπ∏√√¡¥“) ®”π«π 35 §π ‡¡◊ËÕ
„π·μà≈–‡¥Õ◊ π®“°§“à æπÈ◊ ∞“π „π‡¥Õ◊ π∑’Ë 1 (PI0-PI1) ‡¥Õ◊ π ®”·π°μ“¡‡æ»·∫ßà ‡ªπì 2 °≈¡àÿ §◊Õ ‡æ»™“¬ 21 §π ·≈–
∑’Ë 2 (PI0-PI2) ·≈–‡¥◊Õπ∑’Ë 3 (PI0-PI3) ‡æ»À≠ß‘ 49 §π ‡¡Ë◊Õ®”·π°μ“¡√–¥∫— ™—Èπ·∫à߇ªìπ 3 °≈¡àÿ
§◊Õ π—°‡√¬’ π™Èπ— ª. 1 ª. 2 ·≈– ª. 3 ®”π«π 34 §π 17 §π
∑¥ Õ∫§«“¡·μ°μ“à ߢÕß°≈¡àÿ ∑¥≈Õß·≈–°≈¡àÿ §«∫§¡ÿ ·≈– 19 §π μ“¡≈”¥∫— ¥—ßμ“√“ß∑Ë’ 1
‚¥¬‡ª√’¬∫‡∑’¬∫§à“‡©≈’ˬ°“√≈¥≈ߢÕߥ—™π’‡Àß◊Õ°Õ—°‡ ∫®“°
§à“æ◊Èπ∞“π ·≈–§à“‡©≈’ˬ°“√≈¥≈ߢÕߥ—™π’§√“∫®ÿ≈‘π∑√’¬å ¢âÕ¡Ÿ≈¢Õß§à“‡©≈’ˬ·≈–§à“‡∫’ˬ߇∫π¡“μ√∞“π¢Õߥ—™π’
®“°§à“æ◊Èπ∞“π‚¥¬¿“æ√«¡¢Õß∑ÿ°™à«ß‡«≈“ ‚¥¬„™â ∂‘μ‘°“√ ‡Àß◊Õ°Õ—°‡ ∫ ¥—™π’§√“∫®ÿ≈‘π∑√’¬å·¬°μ“¡°≈àÿ¡°“√»÷°…“ ∑’Ë
«‡‘ §√“–À§å «“¡·ª√ª√«π‡¡Õ◊Ë ¡°’ “√«¥— ´È” (Repeated measures ‡«≈“‡√¡‘Ë μπâ (§“à æπÈ◊ ∞“π) ‡¡ÕË◊ ‡¥Õ◊ π∑Ë’ 1 ‡¥Õ◊ π∑Ë’ 2 ·≈–‡¥Õ◊ π∑Ë’ 3
ANOVA) ‡πË◊Õß®“°§à“æÈ◊π∞“π¢Õߥ—™π’§√“∫®ÿ≈‘π∑√’¬å¡’ · ¥ß„πμ“√“ß∑’Ë 2 ‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫§à“æ◊Èπ∞“π√–À«à“ß°≈ÿà¡
§«“¡·μ°μà“ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘μ‘√–À«à“ß°≈àÿ¡∑¥≈Õß ∑¥≈Õß·≈–°≈àÿ¡§«∫§ÿ¡ æ∫«à“§à“‡©≈Ë’¬¥—™π’‡Àß◊Õ°Õ—°‡ ∫
·≈–°≈à¡ÿ §«∫§ÿ¡ °“√«‘‡§√“–À‡å ª√’¬∫‡∑¬’ ∫§“à ‡©≈¬Ë’ °“√≈¥≈ß ‰¡¡à §’ «“¡·μ°μ“à ß°π— Õ¬“à ß¡π’ ¬—  ”§≠— ∑“ß ∂μ‘ ‘ (p = 0.73) ·μà
¢Õߥ™— π§’ √“∫®≈ÿ π‘ ∑√¬’ ‚å ¥¬„™ â ∂μ‘ °‘ “√«‡‘ §√“–À§å «“¡·ª√ª√«π °≈ÿࡧ«∫§ÿ¡¡’¥—™π’§√“∫®ÿ≈‘π∑√’¬å¡“°°«à“°≈àÿ¡∑¥≈ÕßÕ¬à“ß¡’
‡¡◊ËÕ¡’°“√«—¥´”È ®÷ß¡’°“√§«∫§ÿ¡§à“æ◊Èπ∞“π¢Õߥ—™π’§√“∫ π—¬ ”§—≠∑“ß ∂‘μ‘ (p = 0.01) ‡¡Ë◊Õæ‘®“√≥“§à“‡©≈Ë’¬¥—™π’
®ÿ≈‘π∑√’¬å¥â«¬ °“√∑¥ Õ∫∑È—ßÀ¡¥‡ªìπ·∫∫ Õß∑“ß∑’Ë√–¥—∫ ‡Àß◊Õ°Õ—°‡ ∫·≈–¥—™π’§√“∫®ÿ≈‘π∑√’¬å ≥ ‡«≈“ÕË◊πÊ æ∫«à“
π¬—  ”§≠— 0.05 ∑È—ß Õß°≈àÿ¡‰¡à¡’§«“¡·μ°μà“ß°—πÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘μ‘
(p > 0.05)
º≈°“√»°÷ …“
‡¡◊ËÕæ‘®“√≥“§à“‡©≈’ˬ°“√≈¥≈ߢÕߥ—™π’‡Àß◊Õ°Õ—°‡ ∫
„π°“√«®‘ —¬§√—ßÈ π’¡È Õ’ “ “ ¡—§√∑ßÈ— À¡¥ 70 §π ∑’¡Ë ’Õ“¬ÿ ≥ ‡«≈“μ“à ßÊ ®“°§à“æπ◊È ∞“π (¿“æ∑’Ë 1) æ∫«à“∑Èß—  Õß°≈¡àÿ
√–À«“à ß 7-10 ªï ´ß÷Ë ·∫àß°≈ÿ¡à °“√»°÷ …“ÕÕ°‡ªπì 2 °≈ÿà¡ §Õ◊ ¡’°“√≈¥≈ߢÕ߇Àß◊Õ°Õ—°‡ ∫¡“°∑’Ë ÿ¥„π‡¥◊Õπ∑Ë’ 1 ®“°πÈ—π

μ“√“ß∑’Ë 1 ≈—°…≥–¢ÕߺŸ‡â ¢“â √à«¡«®‘ ¬— ·¬°μ“¡°≈¡ÿà
Table 1 Characteristics of study population according to study group

Study group

Characteristics Powered toothbrush Manual toothbrush P-value
0.79a
(N=35) (N=35) 0.95a

Gender Male 11 (31.4) 10 (28.6) 0.87b
School grades Female 24 (68.6) 25 (71.4)
Pratom 1 17 (48.6) 17 (48.6)
Age (years) Pratom 2 8 (22.9) 9 (25.7)
Pratom 3 10 (28.6) 9 (25.7)
Mean ± SD 8.39 ± 0.87 8.36 ± 0.80
Range 7-10
7-10

Data presented as N (%) unless stated otherwise
aChi-square test
bT-test

« ∑—πμ ®ÿÓœ 2554;34:193-202 Õ√Õÿ¡“ Õß— «√“«ß»å ·≈–§≥– 197

μ“√“ß∑Ë’ 2 §“à ‡©≈Ë’¬·≈–§“à ‡∫’ˬ߇∫π¡“μ√∞“π¢Õߧ“à ¥—™π’‡Àß◊Õ°Õ°— ‡ ∫ ·≈–§à“¥™— π’§√“∫®ÿ≈‘π∑√¬’ å·¬°μ“¡°≈à¡ÿ °“√»°÷ …“
Table 2 Mean and standard deviation for gingival and plaque indices by study group

Variable Powered toothbrush Manual toothbrush P-value
0.53 ± 0.24 0.55 ± 0.24 0.73a
Gingival index Baseline 0.42 ± 0.23 0.45 ± 0.20 0.49a
0.45 ± 0.20 0.54 ± 0.27 0.10a
1 month 0.65 ± 0.24 0.77 ± 0.35 0.11a
2.19 ± 0.68 2.62 ± 0.70 0.01a
2 months 1.19 ± 0.66 1.09 ± 0.51 0.48a
0.45 ± 0.30 0.49 ± 0.38 0.60a
3 months 0.77 ± 0.48 0.91 ± 0.51 0.23a

Plaque index Baseline

1 month

2 months

3 months

aT-test

§à“‡©≈Ë’¬°“√≈¥≈ߢÕ߇Àß◊Õ°Õ—°‡ ∫®–≈¥πâÕ¬≈߇√◊ËÕ¬Ê ¿“æ√«¡¢Õß∑°ÿ ™«à ߇«≈“¥«â ¬ ∂μ‘ °‘ “√«‡‘ §√“–À§å «“¡·ª√ª√«π
‡¡◊ËÕ‡«≈“ºà“π‰ª æ∫«à“°≈àÿ¡∑¥≈Õß¡’§à“°“√≈¥≈ߢÕߥ—™π’ ‡¡Ë◊Õ¡’°“√«—¥´”È æ∫«à“§à“‡©≈’ˬ¢Õß∑È—ß 2 °≈àÿ¡‰¡à¡’§«“¡
‡Àß◊Õ∫Õ°— ‡ ∫®“°§à“ 0.11 ± 0.21 „π‡¥◊Õπ∑Ë’ 1 ‡ªπì 0.08 ± ·μ°μ“à ßÕ¬“à ß¡’π¬—  ”§—≠∑“ß ∂‘μ‘ (p = 0.73)
0.24 ·≈– -0.13 ± 0.31 „π‡¥Õ◊ π∑’Ë 2 ·≈–‡¥◊Õπ∑’Ë 3 μ“¡
≈”¥—∫  à«π°≈ÿࡧ«∫§ÿ¡°Á¡’·π«‚πâ¡„π°“√‡ª≈’ˬπ·ª≈߇™àπ «®‘ “√≥å
‡¥¬’ «°π— °≈“à «§Õ◊ §“à °“√≈¥≈ߢÕߥ™— π§’ √“∫®≈ÿ π‘ ∑√¬’ ®å “°§“à
0.10 ± 0.16 „π‡¥◊Õπ∑Ë’ 1 ‡ªìπ 0.003 ± 0.21 ·≈– -0.22 ± ®“°°“√»°÷ …“¢Õß Yankell ·≈– Emling7 æ∫«à“°“√
0.27 „π‡¥◊Õπ∑’Ë 2 ·≈–‡¥◊Õπ∑’Ë 3 μ“¡≈”¥—∫ ‡¡Ë◊Õ«‘‡§√“–Àå „™â·ª√ß ’øíπ‰øøÑ“ “¡“√∂≈¥°“√‡°‘¥‡Àß◊Õ°Õ—°‡ ∫‰¥â¥’°«à“
§«“¡·μ°μà“ß√–À«à“ß°≈àÿ¡‚¥¬¿“æ√«¡¢Õß∑ÿ°™à«ß‡«≈“¥â«¬ ·ª√ß ’øíπ∏√√¡¥“„π™«à ߇«≈“ 1 ‡¥Õ◊ π ´÷Ëß„Àâº≈∑¢’Ë —¥·¬ßâ °∫—
 ∂‘μ‘°“√«‘‡§√“–À姫“¡·ª√ª√«π‡¡Ë◊Õ¡’°“√«—¥´”È æ∫«à“§à“ °“√»÷°…“§√È—ßπÈ’ §◊Õ °“√„™â·ª√ß ’øíπ‰øøÑ“¡’º≈μàÕ°“√≈¥
‡©≈Ë’¬¢Õß∑È—ß 2 °≈àÿ¡ ‰¡à¡’§«“¡·μ°μà“ßÕ¬à“ß¡’π—¬ ”§—≠ °“√‡°¥‘ ‡ÀßÕ◊ °Õ°— ‡ ∫‰¡·à μ°μ“à ß®“°°“√„™·â ª√ß ø’ πí ∏√√¡¥“
∑“ß ∂‘μ‘ (p = 0.19) „π™à«ß‡«≈“‡¥’¬«°—π ´Ë÷ß à«πÀπ÷Ëßπà“®–¡“®“°‰¥â¡’°“√¢Ÿ¥À‘π
π”È ≈“¬°àÕπ∑Ë’®–‡√‘Ë¡∑”°“√«—¥§à“¥—™π’‡Àß◊Õ°Õ—°‡ ∫æ◊Èπ∞“π
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± 0.95 „π‡¥◊Õπ∑Ë’ 1 ‡ªπì 1.74 ± 0.72 ·≈– 1.42 ± 0.71 „π °“√≈¥‡Àß◊Õ°Õ—°‡ ∫Õ“®‡πË◊Õß¡“®“° ¿“«–‡Àß◊Õ°Õ—°‡ ∫
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≈ߢÕߥ—™π’§√“∫®≈ÿ ‘π∑√¬’ ®å “°§“à 1.54 ± 0.81 „π‡¥◊Õπ∑Ë’ 1
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198 Angwaravong O, et al CU Dent J. 2011;34:193-202

Mean gingival index reduction 0.15 23 Powered toothbrush
0.10 Manual toothbrush
0.05 Time (months)
0.00
-0.05 1
-0.10
-0.15
-0.20
-0.25

¿“æ∑’Ë 1 §à“‡©≈Ë’¬°“√≈¥≈ߢÕߥ—™π’‡Àß◊Õ°Õ—°‡ ∫®“°§à“æÈ◊π∞“π ‡¡◊ËÕ«—¥´È”∑’ˇ¥◊Õπ∑Ë’ 1 ‡¥◊Õπ∑’Ë 2 ·≈–‡¥◊Õπ∑Ë’ 3 ¢Õß°≈ÿà¡
·ª√ß ø’ πí ‰øø“Ñ ·≈–°≈¡àÿ ·ª√ß ’øíπ∏√√¡¥“

Figure 1 Mean gingival index reduction from baseline of powered and manual toothbrushing groups at 1, 2 and
3 months

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« ∑π— μ ®Ãÿ “œ 2554;34:193-202 Õ√Õÿ¡“ Õß— «√“«ß»å ·≈–§≥– 199

Mean plaque index reduction 2.50 Powered toothbrush
2.00 Manual toothbrush
1.50
1.00 2 3
0.50 Time (months)
0.00

1

¿“æ∑Ë’ 2 §“à ‡©≈ˬ’ °“√≈¥≈ߢÕߥ—™π’§√“∫®≈ÿ ‘π∑√’¬å®“°§“à æπÈ◊ ∞“π ‡¡◊ÕË «¥— ´”È ∑’ˇ¥Õ◊ π∑Ë’ 1 ‡¥◊Õπ∑Ë’ 2 ·≈–‡¥Õ◊ π∑Ë’ 3 ¢Õß°≈à¡ÿ
·ª√ß ø’ íπ‰øøÑ“·≈–°≈ÿ¡à ·ª√ß ø’ πí ∏√√¡¥“

Figure 2 Mean plaque index reduction from baseline of powered and manual toothbrushing groups at 1, 2 and
3 months

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200 Angwaravong O, et al CU Dent J. 2011;34:193-202

·μ®à “°°≈¡àÿ μ«— Õ¬“à ß∑‰Ë’ ¥¬â ß— æ∫«“à ¡®’ ”π«π‡¥°Á π°— ‡√¬’ π‡æ»À≠ß‘ ‡Õ° “√Õ“â ßÕ‘ß
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«‘®—¬∑Ë’‰¡à‡∑à“°—π Õ¬à“߉√°Áμ“¡ ‡¡Ë◊Õ‡ª√’¬∫‡∑’¬∫√–À«à“ß°≈àÿ¡ FA. CARRANZAûS clinical periodontology. 10th
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Õ¬à“ß¡’π—¬ ”§≠— ∑“ß ∂μ‘ ‘ 2. ™π‘π∑√å ‡μ™–ª√–‡ √‘∞«‘∑¬“. ‚√§ª√‘∑—πμå·≈–°√–∫«π
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202 Angwaravong O, et al CU Dent J. 2011;34:193-202

The effectiveness of powered versus manual

toothbrushing on gingivitis reduction and

plaque removal in children aged 7-10 years

Onauma Angwaravong D.D.S., M.Sc., Dip., Thai Board of Pediatric Dentistry1
Waranuch Pitiphat D.D.S., M.P.H.M., M.S. (Epidemiology), S.D. (Epidemiology), Dip., Thai Board
of Dental Public Health2
Manussanunt Thangwongthawornkit D.D.S.3
Wittavat Rachacrute D.D.S.4

1Department of Pediatric Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen
2Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen
3Nong-Saeng Hospital, Amphur Nong-Saeng, Saraburi
4Seka Hospital, Amphur Sega, Nongkai

Abstracts

Objective To evaluate the effectiveness of powered toothbrush for the gingivitis reduction and the
removal of plaque in comparison with conventional manual toothbrush over a 3-month period.

Materials and methods This randomized controlled trial of seventy primary school students aged
between 7-10 years were randomly assigned into 2 groups of thirty five in each: in the test group using
powered toothbrush and in the control group using conventional manual toothbrush. Gingival index of
Löe & Silness (GI) and Patient hygiene performance plaque index of Podshadley and Haley (PI) were
assessed at baseline and at 1, 2 and 3 months. Mean differences between the study groups were
compared using repeated measures ANOVA with the significance level at 0.05.

Results Over a 3-month period of study, there was no statistically significant difference between
powered and manual toothbrush groups with respect to mean reduction of GI scores from baseline
(p = 0.19). Similarly, no statistically significant difference in the mean reduction of plaque reduction
from baseline was observed between powered and manual toothbrush groups (p = 0.73).

Conclusion There was no difference between powered toothbrush and manual toothbrush in the
improvement of gingival health and removal of plaque over a period of 3 months.

(CU Dent J. 2011;34:193-202)

Key words: bacterial plaque; gingivitis; powered toothbrush