Oral health promotion for preadolescents: A school-based approach

Systematic dental care for schoolchildren remains a great challenge in countries with developing health care systems. Aim: To evaluate the effect of an oral health promotion programme for preadolescents using existing general school health care. Methods: A three-month community trial was designed for a random sample of schools (n=12) in Tehran, Iran, in 2005. A total of 347 third-grade schoolchildren were recruited. Three random clusters, each comprising four schools, made up the intervention and control groups. 1) The first group of children (n=115) worked with educational material on oral health together with their school health-counsellor. 2) In the second group (n=114), parents received via the school an oral health education leaflet and a brushing diary to supervise their child’s tooth-brushing at home. 3) The control group (n=118) received no intervention. Self-administered questionnaires and clinical examinations of children’s gingival health before and after the programme provided data. Children’s oral health-related knowledge and attitudes, and their perceived oral health were queried by statements on a five-point Likert scale. Oral health information resources were also enquired.  Comparisons between groups used ANOVA and Chi². Results: After the programme, children in the intervention groups reported significantly less dental fear (P<0.05) and more benefit from dental care (P<0.01) than controls. Numbers of children with problems in their oral appearance were fewer in the intervention groups than among controls (P<0.01). Gingival health improved significantly for the intervention groups compared to controls (60% vs. 32%, P<0.001). Almost all children (96%) reported their parents and one-third their school health-counsellors (34%) as sources of oral health information. Conclusion: This school-based oral health programme improved preadolescents’ oral health.  Existing general health school systems can be used to promote oral health on a national level.