Comparison of Two School-Based Oral Health Education Programs in 9-Year-Old Children

An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial

Background

Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children.

Methods

A total of 112 children ages 6–12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student’s t-test and analysis of covariance.

Results

All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = − 0.9 to − 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups.

Conclusion

An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

Analysis of the effectiveness of school programs for the prevention of dental diseases: a literature review

Relevance. The high prevalence of dental diseases worldwide and their cumulative process from an early age entail effective strategies for healthy habits promotion. Schools are recommended to include oral health education programs in the curricula to develop a positive attitude to oral hygiene among students. The aim was to review the effectiveness of implementing programs in the school curricula to reduce the dental disease level among schoolchildren.Materials and methods. The research chose programs aimed at improving the dental health of schoolchildren. We considered educational measures on oral health protection, carried out by dentists, nurses or teachers within school programs and curative and preventive measures for schoolchildren aged 6-18 years. We searched the publications on the given topic published between 1999 and 2021 in the database e-LIBRARY.ru and  between 2016 and 2021 in the PubMed database. When selecting articles, the full-text study was compulsory to check the article conformance degree to the inclusion criteria.Results. According to the keyword search, we found 76 publications in the database e-LIBRARY.ru. After the exclusion of duplicates and articles nonconforming to the selection criteria, the review included seven publications. Four studies revealed caries reduction, and two studies demonstrated the improvement of oral hygiene. In the PubMed database, 419 publications were found according to the keyword query. The analysis of the effectiveness of school dental programs included 12 articles. Four studies detected oral hygiene improvement, seven studies – caries reduction, and six studies – dental knowledge and skill improvement.Conclusions. According to Russian and international studies, education without curative and preventive measures isn't effective in dental disease prevention in schoolchildren. Along with instructions and training in practical oral hygiene skills, schoolchildren should use fluoride toothpaste. Fluoride varnish application and fissure sealing are the most effective measures in risk groups.

Comparative Study of Oral Health Education Given by a Dentist and Schoolteachers in Thai Grade 3 Students

Objectives:

To compare children’s knowledge and attitudes toward oral health (OH) and plaque score after receiving OH education (OHE) from a dentist or trained schoolteachers.

Materials and Methods:

Third-grade students in Amphoe Meuang, Nakhon Phanom, Thailand (n = 652), were randomly divided into a dentist group (n = 217), a teacher group (n = 216), and a control group (n = 219). The students’ OH knowledge, attitudes, and plaque scores before the intervention were collected as baseline data. The dentist and the teacher groups received additional OH education sessions by a dentist and trained schoolteachers, respectively. Their immediate post-test knowledge was evaluated after each session, and plaque scores were determined after the brushing session. All groups continued a monthly tooth brushing activity for two months. The final assessment was done at the three-month follow-up.

Results:

The students who received additional OHE by either a dentist or teacher demonstrated improved knowledge and attitudes towards OH, including plaque score. Interestingly, at the three-month follow-up, the knowledge score in the teacher group was significantly higher than in the dentist group. However, the dentist group had a significantly lower plaque score compared with the teacher group.

Conclusions:

Additional OHE in school significantly improved students’ OH knowledge and positive attitudes regardless of the provider. However, the teacher tends to have a greater impact on their students; thus after appropriate training, schoolteachers can be efficient OH educators, especially in the long term.

Impact of practice modification on oral health status of students: An interventional study from a tribal area of India

Context:

Tooth decay precipitated by poor oral hygiene is one of the most common oral diseases that affect 60–90% of school children. It not only interferes with speech, self-esteem but pain caused by decay also affects nutrition intake, resulting in malnutrition with abnormal cognitive development.

Aim:

To evaluate the impact of health education and supervised brushing intervention on their oral health status.

Settings and Design:

Cross-sectional interventional study.

Methods and Materials:

The study was conducted on students of class 8^th, 9^th, and10^th of an Ashramshala (tribal residential school). All the students present in the school on the day of data collection were included in the study. A semistructured questionnaire was used for data collection. A qualified dentist, who is part of research team, conducted oral examination of the students. They were asked to demonstrate their brushing method and relevant observation was noted. The oral health status of the students was analyzed using DMF (decayed, missed, and filled) index and oral hygiene index- simplified score (OHI-S). Three training and educational sessions of one hour each were conducted separately for each class and a separate session was conducted for the teachers and caretakers of the school. Thereafter, randomly selected students (peers) were asked to demonstrate the technique to their peers to ensure proper understanding. Compliance was ensured through weekly follow ups to the school by the research team. DMF score and OHI-S were recalculated after 3 months and compared with their previous scores.

Statistical Analysis:

Chi-square test, one-way analysis of variance and paired t-test were used for analysis.

Results:

The mean DMF and OHI-S score of the students was 2.61+/-2.309 and 2.11+/-0.96, respectively. A significant change (P = 0.021) in OHI scores was observed as a result of intervention.

Conclusions:

Promoting healthy dental practice with supportive supervision form the cornerstone for good health and hygiene.